用于腔镜甲状腺切除手术的磁悬吊系统的研制

Development of a Magnetic Suspension System for Flap Freeing During Laparoscopic Thyroidectomy

目的利用磁悬吊技术的优势特点,提出了一种适用于腔镜甲状腺切除手术皮瓣游离的磁悬吊系统设计。方法该系统由体外支架、磁悬吊单元与内磁体构成,通过改变体外支架承载臂长度和角度可实现整个系统的定位;磁悬吊单元与内磁体相配合,可实现深部皮肤的牵拉,辅助深部狭窄区域的暴露。以巴马猪为实验模型,通过对比新型磁悬吊系统进行腔镜甲状腺切除术与传统手术方式的平均皮瓣游离时间、术者受干扰次数、术中出血量及术后主刀对皮瓣暴露效果的评分,来评价二者的效果。结果磁悬吊系统平均皮瓣游离时间为(39.5±8.3)min,而传统术式为(64.0±21.4)min,两组差异有统计学意义(P<0.05)。磁悬吊组中术者受干扰次数(3±1)次明显低于传统术式组(11±3)次;磁悬吊组出血量显著少于传统术式组;皮瓣暴露效果评分,磁悬吊暴露评分(8±2)分明显优于传统术式(5±3)分;差异均有统计学意义(P<0.05)。结论该系统不仅能够降低腔镜甲状腺切除手术的操作难度,能够实现狭窄部位的定点显露,对于促进腔镜甲状腺切除手术的进步具有重大意义。

Objective Based on the advantages of magnetic suspension technology,a magnetic suspension system for skin flap dissociation in endoscopic thyroidectomy was proposed.Methods The system consists of an external magnet holder,a magnetic suspension unit and an internal magnet.The external magnet holder was combined with the magnetic suspension unit.The entire system was positioned by changing the length and the angle of the external magnet holder carrying arm.The magnetic suspension unit cooperated with the internal magnet to achieve deep skin pulling and assist in the exposure of deep narrow areas.In this study,bama pig was used as the experimental model to evaluate the effect of endoscopic thyroidectomy with the new magnetic suspension system and the traditional method by comparing the average free time of skin flap,the number of interference,the amount of intraoperative blood loss and the score of skin flap exposure by the surgeon.Results The average flap free time of magnetic suspension system was(39.5±8.3)min,while that of traditional operation was(64.0±21.4)min.The difference between the two groups was statistically significant(P<0.05).The number of interference in magnetic suspension group(3±1)was significantly lower than that in traditional operation group(11±3).The amount of blood loss in magnetic suspension group was significantly less than that in traditional operation group.The skin flap exposure score of magnetic suspension(8±2)was significantly better than that of traditional operation(5±3).The differences were statistically significant(P<0.05).Conclusion The magnetic suspension system can not only reduce the operation difficulty of flap fleeing in laparoscopic thyroidectomy,but also achieve better exposure effect,which is of great significance for promoting the progress of endoscopic thyroidectomy.