脊柱弧形自动拉钩的设计与术中应用

Design and Application of a Spinal Arc Auto-retractor

目的 :通过改良手术器械 ,减小手术创伤 ,缩短手术时间 ,节省手术人力。方法 :自行设计“脊柱弧形自动拉钩” ,拉钩由弧形拉钩、万向蛇形管、固定支架 3部分组成。弧形拉钩选不锈钢为材料 ,形状为半圆管状 ,壁厚 0 .1cm ,直径 2 .3cm ,通过万向蛇形管、固定支架与手术床固定。弧形拉钩使手术切口四周的软组织均被弧形拉钩壁阻隔于手术野之外 ,切口显露范围呈半圆形 ,内侧弦弓部为棘突间隙及上位棘突下半与下位棘突上半 ,弧形部为拉钩半圆形壁。结果 :应用“脊柱弧形自动拉钩”施行单节段椎板间隙开窗髓核摘除术共 2 85例 ,平均切口长度 3.0cm ,平均手术时间 41min ,所需手术医生 2人。结论 :脊柱弧形自动拉钩既能有效减少切口长度 ,又能充分显露手术野 ,缩短手术时间 ,节省手术人力。

Objective:To decrease operative trauma,shorten operative time,economize staffs through improving the operative instruments.Methods:Spinal arc auto retractor was designed.It is composed of arc auto retractor?flexible coiled conduit and fixation frame.The arc auto retractor is made of surgical grade stainless steel.It is half round tube shape,the thickness of tube wall is 0.1cm and the diameter of the tube is 2.3cm.It is fixated on the operation table with the frame and the flexible coiled conduit.The operative field was clear and halfround because all the soft tissues were pulled to the lateral.The media side of operative field was the spinous process.Results:The arc auto retractor was applied in 285 operations of single segmental disc remove.The mean length of incision was 3.0cm,the mean operative time was 41 minutes,two surgeons were needed to complete the operations.Conclusion:The arc auto retractor could decrease the length of incision effectively and exposure the operative field sufficiently.It could shorten operative time and economize the staffs.