KR101441320B1 - Surrical equipment set to perform spine surgery microscope of minimum invasion - Google Patents

Abstract

The present invention relates to a surgical equipment set for performing a minimal invasive endoscope spine surgery. To apply a novel UBS surgical procedure, which performs a surgical procedure on a spinal surgical site by inserting a surgical equipment through a secured surgical space after securing a surgical hole by minimal invasion, the surgical equipment set includes: a surgical space securing equipment sequentially inserted into the surgical hole formed on a surgical site to expand the surgical hole so that an access of the surgical equipment is maintained, forming an extrapolated tube shorter than an adjacent interpolated tube to expose the interpolated tube and marking a gradation so that a position of the exposed region is distinguishable, and having an expanding tube including a gradation on an outer surface of a inserting side to manipulate an insertion depth into the surgical hole, and a surgical hole maintaining device which is inserted to maintain the surgical hole; and a surgical equipment including a muscle separation device, which is inserted into the surgical hole through the expansion tube, to separate a muscle from a bone, a pulling device inserted between the bone and the muscle to peel off or remove a nerve, the muscle or a tendon, a cleaning device, which is bent downward in the direction of the surgical site, to inject water to remove a surgical site residue, and a nerve pulling device, which is bent downward in the direction of the surgical site, and having a pulling tip on an end thereof to pull a nerve at the surgical site.

Description

[0001] The present invention relates to a surgical instrument set for performing a minimally invasive endoscopic spinal surgery.

The present invention relates to a surgical tool set, and more particularly, to a minimally invasive endoscopic spine surgery for applying a new-concept UBE procedure capable of performing a spinal surgery operation with minimally invasive surgery and securing a field of view of a practitioner Surgical tool set.

Generally, the vertebra of the human body is a bone structure that forms the spinal column, and includes seven cervical spine, twelve thoracic vertebra, five lumbar vertebrae, , Which consists of a sacrum (补骨) with five sacrum (薦 精 椎), and a coccygeal bone (尾骨) with four cauda vertebrae (tail bone), which are connected by joints. And a disc (aka "disc"). These spines not only support the human posture while cushioning, but also serve as the basis of exercise and protect the organs of all organs.

In such vertebrae, when the intervertebral disc connecting the vertebrae is degenerated or ruptured and deviates from the normal position, or when the joint composed of the proximal vertebrae is damaged or deformed, the vertebrae are deformed and dislocated from the normal position It is known that external force is applied to the nerves passing through the spinal column, or when the nerve is pressed, it causes pain.

Conventional spinal surgery has been performed with relatively large incisions or ruptures in the soft tissues, requiring a long recovery time for the patient. Minimally invasive techniques, which lead to shorter recovery times in spinal surgery, have become increasingly common, and these minimally invasive procedures can reduce postoperative pain, use of anesthetic agents, and loss of blood.

As an example of such a minimally invasive procedure, in Patent Publication No. 10-2012-0075711, a pair of expander pipes whose lower ends can be opened or closed by using a hinge part are used to open the incision part to both sides to secure a treatment space A minimally invasive spinal cord surgical system has been disclosed. However, in order to insert the expander pipe into the treatment site, the technique requires that the treatment site be cut to a minimum size. In order to insert an expander pipe including a hinge, an adjustment bolt, an adjustment link, and a complicated configuration, the skin has to be partially cut or ruptured, which causes considerable damage to the skin or muscles.

In addition, the general surgical instruments inserted into the expander pipe have difficulty in securing the operator's gaze due to the large number of tools having relatively large or long widths, and are restricted in the movement of the surgical tool inserted through the expander pipe. .

Published patent application No. 10-2012-0075711

SUMMARY OF THE INVENTION Accordingly, the present invention has been made keeping in mind the above problems occurring in the prior art, and it is an object of the present invention to provide a minimally invasive procedure for inserting a surgical instrument, The purpose of this study is to provide a set of surgical tools for performing minimally invasive endoscopic spinal surgery that is designed to apply the new concept of UBE to limit the movement of surgical instruments.

In order to achieve the above-mentioned object, the present invention provides a method of operating a surgical instrument, comprising the steps of: expanding a treatment ball while sequentially inserting and holding surgical tools into a treatment ball formed at a surgical site; An enlarged tube which is formed with a graduation on the outer side of the insertion side so as to expose another interpolated tubular body, a scale is displayed on the exposed part so as to identify the position, and an insertion depth of the treatment hole is adjusted; A surgical space securing tool configured to include a surgical procedure holder inserted; A muscle separator inserted in the treatment hole through the expanded tubular body and dropping the bone and muscles, a retractor for separating or removing the nerve, muscles or ligaments between the bones and the muscles, A surgical instrument comprising a washing machine which is bent toward the lower side in the site direction and injects water and a nerve retractor which is bent toward the lower side in the direction of the operation site and has a claw tip formed at the tip for nerve traction at the operation site A set of tools for performing endoscopic spinal surgery is provided.

At this time, the expanding tubular body is formed such that one extruded tubular body is formed shorter than another adjacent tubular body to be interpolated so that the interpolated tubular body is exposed, and the scale is displayed so as to be able to identify the position of the exposed tubular body, And a plurality of openings are provided to correspond to the outer diameter of the extension tube, and both ends of each of the openings are formed as a closed bar shape in a round shape.

In addition, the muscle separator may include a blade portion inserted into the extension tube, a grip portion that is easy to grip, and a gripper hole formed on the grip portion to receive a fingertip holding the grip portion.

In addition, the retractor is provided with a plurality of tip portions formed at both ends thereof at different inclination angles. At this time, a handle capable of being gripped is formed on the retractor.

The washing machine is characterized in that the washing machine is constituted by a handle portion to which a washing water inlet is connected and a water receiving portion formed with a discharge hole facing the surgical site side at an end portion bent toward the lower side in the direction of the surgical site.

The nerve retractor is formed of a grip portion that can be gripped and a connecting portion formed with a pulling tip that is bent again to face the surgical site side at an end portion bent toward the lower side in the direction of the surgical site. At this time, an inflow hole is formed on the side of the hook portion on the connection portion, and a discharge hole connected to the inflow hole is formed on the side of the handle portion.

The surgical tool set for performing the minimally invasive endoscopic spine surgery according to the present invention can secure a surgical hole in a stepwise manner by minimally invasive as much as a desired size in a surgical site so that unnecessary incision is not required in the skin or muscles, And a surgical tool capable of securing a visual field can be inserted through the secured space, so that it is possible to perform the operation, thereby exerting the ability of the operator.

In addition, since there is no limitation in the movement of the surgical tool inserted through the extended tube, it is possible to perform the operation of the spinal column at the same time.

In addition, this surgical tool set can be applied to all lumbar disc herniation (disk) surgery, all lumbar spinal stenosis and intervertebral stenosis surgery, multiple lumbar bone fusion surgery, and some cervical disc herniation and intervertebral stenosis surgery.

BRIEF DESCRIPTION OF THE DRAWINGS FIG.
Fig. 2 is a view showing the constitution of an extension tube according to the present invention
Fig. 3 is a view showing the state of use
FIG. 4 is a diagram showing the configuration of a procedure sharing device according to the present invention
Fig. 5 is an explanatory view
6 is a schematic view of a muscle separator according to the present invention
Fig. 7 is a schematic view of a retractor according to the present invention
8 is a schematic view showing the constitution of the washing machine according to the present invention
FIG. 9 is a view showing the configuration of a neurotractor according to the present invention
10 shows the internal details of Fig. 9
Fig. 11 is a view showing the configuration of the inhaler according to the present invention
Fig. 12 is a view showing the state of use of the surgical tool according to the present invention

Hereinafter, embodiments of the present invention will be described in detail with reference to the accompanying drawings.

The present invention proposes a new concept of UBE (Unilateral Biportal Endoscopy) for endoscopic vertebral surgery. Specifically, the present invention can easily observe and handle the nerves of both sides by approaching one direction rather than both directions based on the center of the vertebra. A set of surgical tools to perform a new concept of minimally invasive endoscopic spinal surgery to create a wide open view and a clear image by making two entrance of surgical instrument passages.

1 to 12, a set of surgical tools for performing minimally invasive endoscopic spinal surgery according to the present invention includes an expandable tubular body 10 and a procedure sharing procedure 20 A space securing tool 100 and a surgical tool 200 including a muscle separator 30, a retractor 40, a cleaner 50 and a neurotrainer 60. [

The extended tube 10 (Dilator) is a device for approaching the endoscopic vertebrae by simple expansion using the elasticity of the skin, minimizing skin incision at the time of approaching the surgical site, A tubular body having different inner diameters and outer diameters as shown in FIG. 1, and one tubular body is arranged extensively and sequentially to adjacent tubular bodies adjacent to each other. To extend the treatment ball 2 while being inserted in order to keep the surgical tool in and out.

In this embodiment, as shown in FIG. 2, the first expanded tube body 11 having an inner diameter of 3 mm and an outer diameter of 5 mm is divided into six sections extending to the sixth extension tube body 16 having an inner diameter and an outer diameter increased by 2 mm, respectively However, the needle can be used in a desired number according to the type of surgery or surgical tool, and the needle is formed to have a length of 5 mm so that the needle can be easily used from the first enlarging tube 11.

The extension tube 10 is marked on the outer surface of the insertion side so that the practitioner can recognize and adjust the depth of insertion of the tube into the treatment hole 2 and is formed to be shorter than other adjacent tubes having an extrapolated tube inserted therein .

As shown in FIG. 3, as shown in FIG. 3, first the enlarged tube body 11 is inserted into the treatment hole 2 with a predetermined depth while checking the scale, and then the adjacent second tube body 12 is inserted into the first extension tube 11). When the second expanding tubular body 12 is extruded by the depth of the first expanding tubular body 11 on the treatment hole 2, the first expanding tubular body 11 is exposed on the second expanding tubular body 12, The first extension tube 11 is pulled out. In the same manner, the procedure ball 2 is expanded while sequentially inserting a plurality of extension tubes 10.

At this time, it is also possible to check whether the multiple extension tubular body 10 is inserted in the surgical site by the same depth by displaying a scale on the exposed side of the extension tubular body 10, and the operator can confirm the position of the extension tubular body 10 It can be grasped at a glance and it is easy to use.

In this way, the surgical instrument can be inserted through the extended tubular body 10 after expanding the procedure hole 2 to a desired size by using the extended tubular body 10.

And a procedure sharing device 20 inserted into the treatment hole 2 to maintain the extended range of the expanded treatment hole 2 by the extension tube 10 is provided.

As shown in FIG. 4, a plurality of diluted procedures (dilators) 20 are provided in different sizes, and both ends of the dilator 20 are formed as a closed bar shape having a round shape. When the operation is not performed for a long time, It can be inserted into the expanded treatment hole 2 to maintain the extended range without damaging the skin.

At this time, the surgical shaper 20 is provided so as to correspond to the outer diameters of the plurality of extension tubes 10 provided as shown in FIG. 5, and is selected and used according to the size of the treatment hole 2 formed by the extension tube 10 .

The procedure space securing tool 100 is provided as the extended tubular body 10 and the procedure sharing device 20.

A muscle separator 30 is provided as a surgical tool 200 that is inserted into the treatment hole 2 through the extension tube 10 and performs spinal surgery.

Muscle detacher (30, Muscle detacher) is a device to secure the surgical space by dropping the bones and muscles of the surgical site, and minimizes damage to bones and muscles when used. 6, the muscle separator 30 is formed by integrally connecting the blade 31 inserted in the extension tube 10 and the handle 35 which is easy to grasp. At this time, if the holding hole 36 is formed on the handle 35, the holding force of the handle 35 is stopped and the finger tips of the finger ring are received in the holding hole 36, thereby increasing the gripping force.

In addition, the blade 31 of the muscle separator 30 should be formed to have a sharp tip or an indefinite shape as shown in FIG. 6 in order not to damage the bones and muscles.

The muscle separator 30 separates the bones and muscles and then enters between the separation spaces, and the retractor 40 is provided to peel off the nerve from the peripheral part, or peel or remove the muscles and ligaments.

As shown in FIG. 7, the retractor 40 is formed in a bar shape having a minimum diameter so as to minimize contact within the surgical site and not to damage it. The diameter of the retractor 40 is 2 ~ 7 mm.

The retractor 40 is used as a double ended retractor by forming the tip portions 41a to 44b at both ends so as to perform peeling and removal. At this time, the tip portions 41a to 44b are provided with a plurality of different inclination angles for selective use to match the surgical site. 7 (a) shows a diameter of 3 to 4 mm, one end 41a has 10 to 20 degrees, the other end 41b has 20 to 30 degrees, and FIG. 7 (b) The diameter of the one end 42a is 40 to 50 degrees and the diameter of the other end 42b is 40 to 50 degrees. (D) of FIG. 7 has a diameter of 4 to 6 mm, one end 44a of 10 to 20 degrees and the other end 44b of 20 to 30 degrees, . At this time, the number of the retractors 40 and the angle of the tips 41a to 44b may be variously provided at various angles so as to be suitable for the surgical environment.

On the retractor (40), a handle (49) is formed so that the operator can easily grasp it. At this time, it is preferable that the handle 49 is formed so as not to deviate from the diameter range of the retractor 40 formed at the minimum.

On the other hand, if there is residue on the surgical site and it is not kept or removed for a long time, a large aftereffect remains on the patient, and the operator's view is blurred during the operation. To prevent this, a washer (50) for injecting water to clean the debris or the like is provided.

The intradiscal irrigator 50 has a handle 51 connected to the wash water inflow port 52 as shown in FIG. 8 and a handle 51 for bending the lower portion in the direction of the surgical site to secure the view of the operator, And a water tube portion 55 having an exhaust hole 56 formed therein. With this configuration, the practitioner can accurately grasp the area to be cleaned while securing sufficient visibility, so that it is possible to perform the cleaning in a short time and to reduce the use of unnecessary washing water.

At this time, the bending internal angle? 1 between the handle 51 and the water receiving portion 55 is preferably 110 to 130 degrees. If the internal angle is 110 ° or less, the operator's eyes are covered by the handle 51. If the internal angle is 130 ° or more, the gaze of the operator must be lowered to see the end of the water tube 55, 8, the discharge hole 56 is formed in the bent portion formed on the end portion of the water tube portion 55, but it may be formed in the direction of the operation portion on the end portion of the straight water tube portion without the bent portion.

The outer diameter of the water tube portion 55 is formed to be 3 to 7 mm so as to be easily inserted into the enlarged tube body 10 and the bending angle of the handle portion 51 and the water tube portion 55 for ensuring the visual field is 100 to 130 Deg.].

And an aspirator 90 for discharging the washing water sprayed from the washing machine 50 and the waste materials and liquid substances generated during the operation to the outside without leaving it at the surgical site. The inhaler (90) sucks up residue, liquid material, and the like by the external water pressure and discharges it to the outside.

11, the suction unit 90 is connected to the discharge port 92 and is foldable to the lower side in the direction of the surgical site in order to secure the view of the operator and a suction hole 97 And a suction pipe portion 95 formed on the suction pipe portion 95. The suction pipe portion 95 is configured to be used in an appropriate size depending on the size of the residue to be removed.

At this time, it is preferable that the bending internal angle alpha 4 between the handle 91 and the suction pipe portion 55 is 130 to 150 degrees.

On the other hand, a neuro-retractor 60 is provided to pull the nerve at the surgical site.

The cannulated root retractor 60 includes a gripping portion 68 which can be gripped as shown in FIG. 9, a pulling tip 67 bent to the lower side in the direction of the surgical site and bent again toward the surgical site, And a connecting portion 65 formed thereon.

At this time, it is preferable that the bending internal angle? 2 between the handle 68 and the connecting portion 65 is 100 to 120 degrees. If the angle is less than 100 °, the operator's eyes are covered by the handle 68. If the angle is 120 ° or more, the operator's gaze must be lowered to see the end of the connector 65, The reason why the bending internal angle? 2 in the neurotractor 60 is smaller than the bending internal angle? 1 in the washing machine 50 by 10 degrees is that the distal end of the connecting portion 65 of the neurotractor 60 This is because the hook-and-mouth tip 67 is bent toward the side of the hook.

The bending internal angle? 3 of the wicking tip 67 bent on the connecting portion 65 is preferably 120 to 150 degrees so as to be advantageous for traction and the connecting portion 65 can be easily inserted Preferably 5 to 9 mm.

10, the neuro-retractor 60 is provided with an inflow hole 61 on the side of the claw tip 67 on the connecting portion 65 and an outlet 61 connected to the inflow hole 61 on the side of the handle 68, So that the liquid material generated in the surgical site is naturally discharged to the outside through the inflow hole (61) and the discharge hole (62). At this time, the inlet hole (61) and the exhaust hole (62) are formed on the connecting portion (65).

The surgical tool 200 is provided as the muscle separator 30, the retractor 40, the cleaner 50 and the neurotractor 60 so that the surgical-space securing tool 100 and the surgical tool 200 according to the present invention are provided. To provide a set of surgical tools for performing minimally invasive endoscopic spinal surgery.

In addition, as shown in FIG. 12, since the surgical tool 200 (for example, 60) inserted through the extension tube 10 can be moved freely, there is no restriction on the movement thereof, .

2: surgical ball 10: expander
20: Procedure sharing 30: Muscle separator
31: blade portion 35: handle portion
36: Retention hole 40: Retractor
49: handle 50: washer
51: handle 52: wash water inlet
55: Water tube 56: Exhaust hole
60: nerve retractor 61: inflow ball
62: Exhaust hole 65: Connection
67: pulling tip 68: handle portion
90: Inhaler

Claims (9)

(2) is inserted into the treatment ball (2) formed at the operation site in order to keep the surgical tool in and out, and one tube extruded is formed shorter than the adjacent other tubular body inserted, An enlarged tube body 10 on which a scale is displayed so as to be able to identify a position on the exposed part and a scale is displayed on the outer side of the insertion side so as to adjust the insertion depth of the treatment hole 2, A procedure space securing tool (100) including a procedure shaper (20) to be inserted to hold the operation space.
A muscle separator 30 which is inserted into the treatment hole 2 through the extension tube 10 to drop the bone and muscle and a retractor 30 which is inserted between the bone and the muscle and separates or removes the nerve, 40), a washer (50) for inflating water to the lower side of the surgical site in order to remove debris from the surgical site, and a claw tip (67) And a surgical tool (200) comprising a neurotraining unit (60) formed on the nerve retractor (60).
delete The method according to claim 1,
The surgical shaper 20 is provided to correspond to the outer diameter of the extension tube 10, and each end of the surgical shaper 20 is formed in the form of a closed bar having a rounded shape. In order to perform the minimally invasive endoscopic spinal operation Surgical tool set.
The method according to claim 1,
The muscle separator 30 is formed by connecting a blade 31 inserted into the extension tube 10 and a handle 35 which is easy to grasp and is formed on the handle 35 with a fingertip Wherein a gripping hole (36) is formed to receive the endoscopic instrument.
The method according to claim 1,
Wherein the retractor (40) is provided with a plurality of tip portions (41a to 44b) having inclination angles different from each other at both end portions thereof. The set of surgical tools for performing minimally invasive endoscopic spinal surgery.
6. The method of claim 5,
Characterized in that a retractable handle (49) is formed on the retractor (40) to form a minimally invasive endoscopic spine surgery.
The method according to claim 1,
The washing machine 50 includes a handle 51 having a washing water inlet 52 connected thereto and a water tube 55 having a discharge hole 56 formed at an end portion bent toward the lower side in the direction of the surgical site, Wherein the surgical instrument is configured to perform minimally invasive endoscopic spine surgery.
The method according to claim 1,
The nerve retractor 60 includes a grip portion 68 capable of being gripped and a connecting portion 65 having a distal end portion bent toward the lower side in the direction of the surgical site and formed with a retraction tip 67 bent toward the surgical site side A surgical instrument set for performing minimally invasive endoscopic spinal surgery.
9. The method of claim 8,
An inlet hole 61 is formed on the side of the hook tip 67 on the connecting portion 65 and an outlet hole 62 connected to the inlet hole 61 is formed on the side of the handle portion 68. [ A set of surgical tools for performing invasive endoscopic spinal surgery.

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