一种可变径的腹腔穿刺器的结构设计

The Physical Design of a Abdominal Trocar with Variable Diameter

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摘要目的为解决在腹腔微创手术中所使用的穿刺器,因手术器械规格的不同,而在同一穿刺套管上使用导致漏气,无法有效建立气腹的问题。方法通过对腹腔穿刺器产品结构特点的研究、手术器械规格的调研以及腹腔微创手术步骤和方法的咨询,设计一种创新性的可变径穿刺器。它通过穿刺器上旋盖的旋转运动,带动其内部的拨盘同步旋转,进而驱动滑块做直线往复运动,使孔径变大与缩小,进而配合所使用的手术器械的直径大小,以保证腹腔镜手术气腹的密封性能。结果旋盖的旋转手感轻巧,滑块运动顺畅。在手术器械的压力下,滑块自锁可靠,孔径不会发生改变。旋盖扭力很小(Fr=5.8×10-3N,F′r=3.3×10-3N),旋转轻松。密封可靠,无泄漏,可有效建立气腹。结论可变径的腹腔穿刺器结构设计紧凑,在设定的空间内可实现运动轨迹、旋转角度等的优化设计,并通过力学的分析及计算,对产品旋转力、自锁性能进行了分析,在原理上证明了该种旋臂驱动滑块的变径机构的合理性与可靠性。而样机测试结果也验证了该结构不仅完全符合设计的预期要求,而且实现了产品设计的要求,可充分满足临床的实际应用。 Objective To solve the problem of trocar used in laparoscopic surgery, due to the different diameter of surgical instrument used on the same trocar sheath lead to leakage, and unable to establish pneumoperitoneum effectively. Methods Through the study of the characteristics of trocar structure, the investigation of the specifications of surgical instruments, the consultation of the procedures and methods of celiac minimally invasive surgery, we designed an innovative trocar with variable diameter. It drove the synchronous revolution of internal dial by the rotary motion of screw-cap on the trocar, and then drove the slider do straight reciprocating motion, enlarged and narrowed the aperture to match the diameter of surgical instruments, ensured the sealing performance of pneumoperitoneum during laparoscopic surgery. Results The rotating feeling of screw-cap was much light, the slider moved smoothly. The self-lock of slider was reliable and the aperture did not change under the pressure of surgical instruments. The unscrewing torque of screw-cap was small（Fr= 5.8 ×10^-3N, F＇r= 3.3 × 10^-3N）, and the rotation was very easy. The sealing was reliable without leaking, the pneumoperitoneum could be established effectively. Conclusions The trocar with variable diameter has compact structure design, and can perform an optimization design（including motion trail, rotation angle and so on） within the limitative space. And through the mechanical analysis and calculation of rotary force and self-locking performance of the product, it has been proved that the mechanism with variable diameter of this slewing drive slider is reasonable and reliable in principle. The prototype test results also show that this structure not only fully meet the expected design requirements, but also reach the requirement of product design, which can fully satisfy the clinical application.