新式腹腔鏡手術打結器之研發

Abstract

本論文主要是研發可用於腹腔鏡手術的新式縫線打結器。傳統的體內打結法因腹腔內空間狹小，致使纏繞與拉緊縫線的動作不易操作；體外打結法又因縫線拉出體外纏繞而有耗時與縫線消耗較大的問題，故本研究主要目標為設計出容易操作的腹腔鏡手術縫線打結器與其打結方法。此新式縫線打結器透過簡單的雙卡榫設計，讓縫線於體外以特定方向預先纏繞活結於打結器上，再置入體內以輔助器械配合操作推結與拉緊縫合的步驟。此新式打結器相較於傳統體內打結法，能免於操作體內複雜的纏繞流程，大大降低體內打結難度；而相較於體外打結則更省時也同時節省縫線使用量。在此以簡易的實體原型模擬實際打結流程，以確認所提出設計的可行性，並探討操作測試結果。

Here a new suture tying instrument for laparoscopic surgery is proposed and design. Because of the narrow abdominal cavity, motions like winding and ligating are hard to perform in traditional intracorporeal tying method .By winding suture out of abdominal cavity, extracorporeal tying method also consumes more operation time and more suture. Therefore, an easy-operative suture tying instrument and method of tying a suture for laparoscopic surgery is developed here. The new suture tying instrument which has dual latched design can pre-tied the square knot out of abdominal cavity in a specific way. The instrument is put into abdominal cavity for operating knot pushing and ligating in coordinate with an assistant grasper. The new suture tying instrument can greatly reduce the difficulty in operating tying procedure rather than intracorporeal tying method. Also the new instrument saves more time and more suture than extracorporeal tying method. Here a simple prototype is built for simulating tying procedure to verify the feasibility of the proposal design.