| 摘要 |
A tissue manipulation apparatus and method of use is provided to enable remote holding and multidirectional movement of tissue, such as the prostate gland to aid in its surgical removal during prostatectomy. The apparatus has a housing and a shaft extending from the housing which curves to a distal end. The shaft is insertable through a natural or surgical opening or channel in the body of a patient, such as the urethra of a male patient to access the patient's prostate gland. Tissue engaging members in the distal end are actuated by a longitudinal drive mechanism through the shaft from their retracted position at the distal end to extend into the tissue. The distal end is rotatable by a rotational drive mechanism extending through the shaft to the distal end. The longitudinal and rotational drive mechanisms are independently operated at the housing. The tissue once held by the tissue engaging members may be manipulated in its position under control of the operator of the apparatus, such as, raised or lowered by adjusting the tilt angle of the shaft, pulled or pushed by changing the extent of the shaft passing through the opening or channel to access the tissue, and bi-directional rotated via the rotational drive mechanism. In a prostatectomy, for example, the distal end is located in the prostate through the urethra and the tissue engaging members are extended. The operator can position the prostate to expose and place tissue surrounding the prostate under tension during dissection, while minimizing damage to surrounding tissue structures. The apparatus may further provide internal channels to facilitate the insertion or removal of liquids or gases from the site of tissue engagement. After dissection is complete, the tissue engaging members are retracted in the distal end to their retracted position via the longitudinal drive mechanism, and then the shaft and distal end is removed from the patient.
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