CN100409825C - Nasal Endoscopic Surgery Support Assist System - Google Patents

Abstract

The support auxiliary system for nasal endoscopic surgery belongs to the field of medical equipment for nasal endoscopic surgery, and consists of three parts: nasal endoscopic bracket, continuously variable flushing suction system and nasopharyngeal sealing air bag. The good flexibility and instant braking function of the nasal endoscope bracket meet the needs of frequent movement, fixation, and replacement of the position and angle of the lens body during the operation, and realize two-handed operation; the infinitely variable flushing suction device system flushes the lens in real time during the operation, ensuring The operation field is clear, reducing or even eliminating the traditional cumbersome operation of taking out the endoscope to wipe the lens during the operation; the nasopharyngeal sealing airbag seals the nasopharynx by compressing the soft palate to reduce the liquid flowing into the oral cavity and facilitate flushing. The invention is designed to improve the operation of endoscopic surgery, and its main purpose is to realize the two-handed operation of endoscopic surgery and maintain a clear surgical field. The bracket part can also be used as a bracket for other instruments, and the continuously variable speed flushing suction device system part can also be used in medical operations where flushing suction needs to be replaced frequently.

Description

Nasal Endoscopic Surgery Support Assist System

technical field

The invention belongs to the field of medical instruments for nasal endoscopic surgery.

Background technique

Since the 1970s, nasal endoscopic technology has been widely used and has become a milestone in nasal surgery. However, the three shortcomings of nasal endoscopic devices, namely, one-handed operation, bloody lens, and flat vision, have not been well resolved so far. , so that many operations are difficult to perform finely, especially in areas where there is a lot of bleeding and one-handed operation is difficult to complete, which seriously restricts the development of nasal endoscopic technology.

Since the 1990s, there have been new works to explore the production of endoscope brackets. According to whether motor drive is required, it can be basically divided into two categories: driven device (without motor drive) and active device (with motor drive). Manipulator) ^[1] However, most of the devices are designed for surgical operations, and the devices specially designed for nasal operations are rarely reported in domestic and foreign literature ^[2] . In recent years, highly intelligent devices can solve some problems and have begun to be applied It is used in rhinology clinical practice, but the high cost of replacing equipment, the change of long-term operating habits and the time-consuming and laborious retraining of doctors have caused headaches for clinicians who are already busy with work, and because of the structure of the human body. Highly personalized, it is difficult for clinicians to accurately describe the spatial position of a human body with numerical control methods, ^[3][4][5] and manual is an accurate and reliable method, and more importantly, through manual , the doctor can feel the depth of the instrument and the nature of the tissue touched. After comparing more than 70 kinds of lenses and support devices of surgical instruments that have appeared in the past ten years, it is believed that the active device can provide an ideal and stable surgical field. There is no difference from the driven device, but considering that the driven device is much superior to the active device in terms of simple structure, small size, and low cost, the advantages of the active device are questionable ^[1] . Domestic Zheng Shunchang (Patent No. 98219896.5) and Li Keyong ^[6] designed nasal endoscope brackets in 1998 and 2001 respectively, but also due to the complicated operation and backward braking device, they did not cooperate with the flushing suction device to solve the problem of blood stained lens and the endoscope Take down the disadvantages such as time-consuming installation, fail to be promoted clinically.

Some people have also made efforts to invent a device that can flush and attract at the same time. For example, someone abroad installed monopolar coagulation, suction tube or flushing tube and a 0-degree, 4mm rigid endoscope in an integrated device. It is used in neurosurgery, but this will inevitably increase the diameter of the device, and the space in the nasal cavity is limited, so this device is difficult to apply to nasal surgery ^[7] .

references:

1. Joris. Camera and instrument holders and their clinical value minimally invasive surgery. Surg Laparosc Endosc Percutan Tech. 2004 June, 14(3) 145-152

2. Xie Minqiang. New equipment related to nasal endoscopic surgery. Chinese Journal of Otorhinolaryngology and Skull Base Surgery. 20019, 7(3) 190-193

3. Pablo Cappabianca. Endoscopy and tanssphenoidal surgery. Neurosurygery. 2004 May, 54(5) 1043-48

4. Jack B.Anon.Computer-assisted endoscopic sinus surgery.Advances in sinus and nasal surgery.1997 June 30(3)389-401

5. Marc O. Schurr. Robotics and systems technology for advanced endoscopic procedures: experiences in general surgery. Europan Journal of Cardio-thoracic Surgery 16(suppl.2)(1999)s97-s105

6. Li Keyong. Preliminary clinical application of propped nasal endoscope. Chinese Journal of Otorhinolaryngology 200110, 36(5)386

7. kshi A, A multifunctional, modified rigid neuroendoscopic system: clinical experience with 83 procedures.Technical note.JNeurosurg.2003Aug;99(2):421-5.

Contents of the invention

The present invention fully considers and overcomes the various shortcomings of similar or related devices at home and abroad, and aims to solve the problems of one-handed operation and bloody lens in current nasal endoscopic surgery through this system, and does not increase surgical operations. cumbersome. The good flexibility and instant braking function of the nasal endoscope bracket in this system meet the needs of frequent movement, fixation, and replacement of the position and angle of the lens body during the operation, and realize two-handed operation; the continuously variable flushing suction device system flushes in real time during the operation The lens absorbs blood and dirt to ensure a clear surgical field, reducing or even eliminating the traditional operation of taking out the endoscope to wipe the lens during the operation; the nasopharyngeal sealing airbag seals the nasopharynx by pressing the soft palate to reduce the liquid flowing into the mouth and facilitate washing.

For this reason, the present invention provides a kind of nasal endoscopic operation supporting auxiliary system, comprises three parts of nasal endoscopic bracket, continuously variable flushing aspirator system and nasopharyngeal sealing air bag, three independent parts of this system form a whole and Cooperate with each other, wherein the nasal endoscope support is composed of slide rails and electromagnets, which can reach any position in the operation and can be locked at any time. The continuously variable flushing suction system is composed of two inner and outer sleeves The three-way device composed of empty tubes can be replaced by the rotation of the inner tube for flushing or suction. During the operation, the lens can be flushed in real time and the operation cavity can be cleaned. The suction head of different angles can be replaced according to the actual situation during the operation. The nasopharyngeal The closed air bag is an air bag adapted to the size of the oral cavity, which closes the nasopharynx by compressing the soft palate.

The technical key of this invention is that its bracket part can make its terminal equipment reach any position that the doctor wants to reach, its movement has almost no resistance, and its locking is reliable. A button on the manipulator controls all the electromagnets, which is completed instantaneously; the flushing and suction function of the flushing suction device is realized through a tube, and the flushing and suction function conversion is completed by the rotation of the knob, and the flushing and suction force It is adjustable; it seals the nasopharyngeal cavity of the patient through a nasopharyngeal sealing air bag, which is beneficial to flushing or suction during the operation; it also solves the problem at the same time, and the good fuzzy control fully considers the doctor's previous operating habits, and the doctor does not need to The training, surgical operation is exactly the same as before, only more convenient.

Description of drawings

Concrete structure of the present invention is provided by following accompanying drawing

Figure 1 is a schematic diagram of the overall view of the nasal endoscope stent.

Fig. 2 is a schematic diagram of the lockable rotary sleeve rod connection.

Fig. 3 is a schematic diagram of the lockable sliding sleeve rod connection assembly.

Fig. 4 is one of the schematic diagrams of the lockable rotary sleeve rod connection combination.

Fig. 5 is the second schematic diagram of the lockable rotation sleeve rod connection combination.

Fig. 6 is a schematic diagram of the card mirror manipulator.

Figure 7 is a schematic diagram of the combination of ball bearings with a rotating sleeve rod structure

Figure 8 Schematic diagram of the continuously variable flushing aspirator system.

Figure 9 is a schematic diagram of a positive (negative) pressure regulator.

Figure 10 Schematic diagram of nasopharyngeal sealing air bag

Detailed ways

As shown in Figure 1: the nasal endoscope bracket is a "factory"-shaped bracket, and its supporting part is a lockable rotating sleeve rod structure 3, and the supporting rod 4 can be rotated and locked in it, using a guide rail that can slide horizontally 11 is used as a beam, its slider 10 can slide horizontally on the guide rail 11, and the vertical sliding rod 12 can slide up and down under the restriction of the slider 10. The guide rail 11 and the vertical sliding rod 12 are not cylindrical, so the slider 10 and the vertical The sliding rods 12 cannot rotate. The lower end of the vertical sliding rod 12 is connected with the vertical rotating rod 14 through a lockable rotating sleeve rod connection 13. The lower end of the vertical rotating rod 14 is connected with a lockable rotating sleeve rod connection combination 15. The connection combination 15 can make the fixed rod 16 of the card mirror hand rotate and axially rotate in the vertical plane of various angles. The mirror manipulator 20 can be taken off for disinfection. All movable joints and their combinations 3, 10, 13, 15 can be locked or opened by electromagnets, and can be opened or locked uniformly through a parallel circuit (the control switch 22 is arranged on the card mirror hand fixing rod 16), and through the first pulley 8 Add a counterweight 6 on the other side of the support rod 4 with the second pulley 9, so that the upward force on the terminal equipment endoscope is equal to the gravity, and the doctor can easily and arbitrarily fix the endoscope at any position, any angle.

As shown in Figure 2, the lockable rotating sleeve rod is connected as a device locked by an electromagnet, and the rotatable rod 27 (that is, 4 or 14) is combined with the inner surface of the first bearing 23 and the second bearing 26, the first bearing 23, The outer surface of the second bearing 26 is fixed with the shell 24 of the electromagnet 28, and the head of the electromagnet armature 29 and the corresponding part of the rotatable inner rod are all engraved with matching card patterns. When the electromagnet is in the power-off state, the armature 29 is ejected by the spring 30, and the card pattern on the head is locked with the corresponding part of the rotatable inner rod, and the rotatable rod 27 is locked. When the electromagnet is energized, the armature 29 is locked. Inhale and separate from the bayonet 25 on the rotatable rod 27, and the rotatable rod 27 can rotate.

As shown in Figure 3: the slider 10 is a lockable sliding sleeve rod connection combination, that is, a combination of two non-cylindrical sleeve shaft structures that are not on the same plane. The head of the armature 32 of the electromagnet 31 is engraved with the card pattern 34 that cooperates with it, and the surface corresponding to the armature 38 of the vertical slide bar 12 and the electromagnet 37 is also engraved with the card pattern that cooperates mutually, when the electromagnet 31 and the electromagnet When 37 is not energized, the armature 32 is locked with the guide rail 11, and the armature 38 is locked with the vertical sliding rod 12. The two rods are fixed. The rods 12 are separated respectively, and the two rods can slide mutually relative to the slide block 10 .

As shown in Figure 4, the structure of the lockable rotary sleeve rod connection assembly 15 is a combination of two lockable rotary sleeve rod connections (Fig. 2) in different directions, that is, the lockable rotary sleeve rod connection assembly 15 can be Rotate, and be locked or released by the electromagnet 41 , the card mirror hand fixing rod 16 can rotate axially, and can be locked or released by the electromagnet 43 . The control switch 22 is the main switch of all electromagnets, and all the electromagnets of the device are connected through a parallel circuit, and are controlled by the control switch 22 to energize or de-energize simultaneously.

As shown in Figure 5, it is another realization form of the lockable rotating sleeve rod connection assembly 15, that is, the electromagnet d41 is fixed, and the electromagnet e43 rotates relatively.

As shown in Figure 6, the card mirror manipulator 20 of the nasal endoscope bracket part is made up of two stainless steel plates that can move each other. The tightness of the mirror, the card mirror hole 21 is in the middle of the card mirror plate 46, opening to one side, and the diameter is 4mm. The card mirror manipulator can be taken off from the card mirror hand fixed rod 16 by loosening the screw 17 for disinfection.

As shown in Figure 7, the outer surface 50 of the composite bearing of the rotating sleeve rod structure ball bearing is combined with the outer tube 2, the vertical sliding rod 12, and the inner surface of the shell 24. 4, 14, 27, 40, 45) combined, this structure can make smooth mutual rotation between the outer tube and the inner rod.

As shown in Figure 8, the continuously variable flushing suction device system (Fig. 8) partly passes through the flushing suction conversion pipe 55 and the positive pressure regulator 64, the negative pressure regulator 75, the positive pressure bottle 62, the negative pressure bottle 73 and its connections. Part of the rubber tube composition. The flushing suction conversion pipe 55 is an assembly structure composed of an outer pipe 56 and an inner pipe 70. There are openings on both sides of the outer pipe 56: a flushing water interface 57 and a negative pressure interface 71. The inner pipe 70 has an opening 58 on the side wall, through which the knob 61 Rotate to make the opening 58 communicate with the flushing water interface 57 and the negative pressure interface 71 respectively to realize flushing and suction conversion. The front end of the inner pipe is a joint, which can be connected with various existing suction heads. There are touch switches on both sides of the knob 61, respectively, the first motor 66 turns on the switch 60 and the second motor 77 turns on the switch 72, and the wall of the outer tube 56 has a positive adjustment switch 69 and a negative adjustment switch 59,60. 72,69,59 are all touch switches, and the flushing suction conversion tube 55 can be separated from the rubber tube at the flushing water interface 57 and the negative pressure interface 71 for disinfection.

As shown in Figure 9, the structure of the positive pressure regulator 64 or the negative pressure regulator 75 is that the air passage 80 (ie 68 or 79) can be partially blocked by the slide block 81 (ie 65 or 76), and the movement of the slide block 81 is determined by The motor 82 (ie 66 or 77 ) is driven by rotating clockwise or counterclockwise, and the movement of the motor is controlled by the switches 60 , 72 , 59 , 69 .

As shown in Figure 10, the nasopharyngeal sealing air bag is an air bag 83 that can be inflated by a valve 85 and a ventilation tube 84, and is 130ml, 80ml, and three kinds of specifications of 40ml spherical air bag, which can meet the needs of patients of different age groups.

The specific working conditions of the present invention are described below.

Before the operation begins, parts 1-17 and 22 of the bracket are fixed on the operating bed, and parts 9-17 face outside the bed. After the general anesthesia takes effect, insert the nasopharyngeal sealing airbag into the back of the patient's mouth, inflate the nasopharynx appropriately, and seal the nasopharynx. The bracket outer cover is a sterile endoscope cover, and a small opening is left in the draw-in slot of the card mirror hand fixing rod 16, and the sterilized card mirror manipulator 20 is stuck on the card mirror hand fixing rod 16, and the endoscope cover is fastened and closed. Small mouth. The endoscope is fixed on the card mirror manipulator 20 by the card mirror screw 19, and the control switch 22 is pressed, and the endoscope is directly pulled to the position required for the operation, and then the hand is released, and the bracket is locked (during this process, Since the armatures are sucked in after electrification, each joint can move flexibly, through the horizontal rotation of the lockable rotating sleeve rod connection 3 and the horizontal sliding of the lockable sliding sleeve rod connection combination 10 on the guide rail 11 to adjust the position of the horizontal plane, through the vertical sliding rod 12 Slide up and down to adjust the height of the endoscope, adjust the horizontal angle of the endoscope through the rotation of the vertical rotating rod 14, adjust the vertical angle of the endoscope through the rotation of the lockable rotating sleeve rod connection combination 15, and adjust the vertical angle of the endoscope through the lock Adjust the axial angle of the endoscope to the ideal position by the axial rotation of the fixed rod 16 of the mirror hand. After the control button 22 is released, each electromagnet will be powered off, and the armature will be ejected. is locked.). The doctor can realize two-handed operation. The left hand holds the flushing suction device conversion tube 55, adjusts to the suction state, turns on the switch 60, and holds the knife, forceps or curette and other surgical instruments in the right hand, while suctioning and cutting, through the positive adjustment switch 69 and the negative adjustment switch 69. The switch 59 properly adjusts the size of the suction. When there is a bloody lens or the surgical field is blurred, turn the knob 61 to the flushing state and then turn on the switch 72. Also adjust the flushing size appropriately through the positive adjustment switch 69 and the negative adjustment switch 59, and the flushing is completed. Afterwards, the knob 61 is turned back to the suction state, the dirty blood is sucked, and the operation can be continued after the operation field is clear, and the whole process does not need to take out the endoscope, flushing suction pipe and surgical instruments.

Claims (8)

1. nasal enterscope operation supporting-aid system, comprise the intranasal mirror support, infinitely variable speeds flushing aspirator system and nasopharynx closed airbag three parts, three independent sectors of this system constitute an integral body and cooperatively interact, wherein said intranasal mirror support is by slide rail, the support that electric magnet is formed can reach any position in the art and can lock at any time, the three-way device that described infinitely variable speeds flushing aspirator system is made up of the blank pipe that is nested together inside and outside two, can be replaced by flushing or attract function by the rotation of interior pipe, in art, wash camera lens in real time, cleaning art chamber, can change the suction aspirator tip of different angles according to concrete condition in the art, described nasopharynx closed airbag is an air bag that adapts with oral cavity size, by compressing soft palate sealing nasopharynx part, it is characterized in that: described intranasal mirror support is one " factory " font support, its support section is a lockable rotation loop bar structure (3), support bar (4) can rotate within it or be locked, utilize one can horizontal slip guide rail (11) as crossbeam, its slide block (10) is that a lockable sliding bar set connects combination, can go up horizontal slip at guide rail (11), vertical sliding bar (12) can be done under slide block (10) restriction and slide up and down, guide rail (11) all is not cylindrical with vertical sliding bar (12), so slide block (10) all can not rotate with vertical sliding bar (12), vertical sliding bar (12) lower end connects (13) by lockable rotation loop bar and links to each other with vertical swingle (14), vertical swingle (14) termination one lockable rotation loop bar down connects combination (15), buckle mirror hand fixation pole (16) can and axially be rotated at the vertical plane internal rotation of all angles, buckle mirror hand fixation pole (16) is a tubular structure, card mirror mechanical hand (20) can be fixed in it, all mobilizable joints and combination (3 thereof, 10,13,15) all can be by locked with electromagnet or opening, by the parallel circuit unification each electric magnet is opened or locking, gauge tap (22) is located on the buckle mirror hand fixation pole (16), add a counterweight (6) by first pulley (8) and second pulley (9) at support bar (4) opposite side, make suffered power that makes progress of terminal unit endoscope and gravitational equilibrium.

2. nasal enterscope operation supporting-aid system according to claim 1, it is characterized in that: the lockable rotation loop bar of described intranasal mirror support is connected to a device by locked with electromagnet, described vertical swingle (14) combines with the inner face of clutch shaft bearing (23) and second bearing (26), the shell of the outside of bearing and electric magnet (28) is fixed, the head of electromagnet armature (29) all is carved with the card stricture of vagina that can cooperate with described vertical swingle (14) corresponding site, the structure that lockable rotation loop bar connects combination (15) is the combination that two lockable rotation loop bars are connected different directions, is implemented in vector potential and axial motion by combination.

3. nasal enterscope operation supporting-aid system according to claim 1, it is characterized in that: the lockable sliding bar set of described intranasal mirror support connects combination (10) for not in the combination of two sleeves of conplane non-cylindrical, be carved with card stricture of vagina (35) below guide rail (11) top smooth, the head of the armature (32) of its corresponding electric magnet (31) is carved with the card stricture of vagina (34) that is mated, and vertical sliding bar (12) also is carved with the card stricture of vagina that cooperatively interacts with the corresponding face of armature (38).

4. nasal enterscope operation supporting-aid system according to claim 1, it is characterized in that: the card mirror mechanical hand (20) of described intranasal mirror support is two and can forms by mutual active corrosion resistant plate, card runner plate (46) is movable relatively, can pass through the length of the rotation regulation and control card mirror screw rods (47) of fixed screw (18), regulate the elasticity of card mirror, card mirror hole (21) is positioned in the middle of the card runner plate (46), to a side opening, diameter is 4mm, card mirror mechanical hand (20) can take off by loosening screw (17) from buckle mirror hand fixation pole (16), carries out disinfection.

5. nasal enterscope operation supporting-aid system according to claim 1 is characterized in that: described infinitely variable speeds flushing aspirator system attracts crossover connection (55) and positive voltage regulator (64), draft regulator (75), malleation bottle (62), negative pressure bottle (73) by flushing and is connected the rubber tube composition of each several part.

6. nasal enterscope operation supporting-aid system according to claim 5, it is characterized in that: it is package assembly by outer tube (56) and interior pipe (70) that the flushing of described infinitely variable speeds flushing aspirator system attracts crossover connection (55), there is opening the both sides of outer tube (56): flushing water interface (57) and negative pressure interface (71), interior pipe (70) sidewall has opening (58), can pass through knob (61) rotation, its opening is communicated with flushing water interface (57) and negative pressure interface (71) respectively, realize that flushing attracts conversion, the front end of interior pipe is a joint, can join with existing various suction aspirator tips, switch is respectively touched in the both sides of knob (61), be respectively that first motor (66) is connected switch (60) and second motor (77) is connected switch (72), positive tune switch (69) and negative tune switch (59) are arranged on the wall of outer tube (56), flushing attracts crossover connection (55) to separate with the rubber tube that flushing water interface (57) and negative pressure interface (71) are located, and carries out disinfection.

7. nasal enterscope operation supporting-aid system according to claim 5, it is characterized in that: the structure of positive voltage regulator (64) and draft regulator (75) is that airway (80) can be stopped by slide block (81) part, the motion of slide block (81) by motor (82) clockwise or rotate counterclockwise and drive, and the motion of motor is controlled by switch (60,72,59,69).

8. nasal enterscope operation supporting-aid system according to claim 1, it is characterized in that: described nasopharynx closed airbag is one can pass through an one-way cock (85) and breather (84) inflatable air bag (83), be respectively 130ml, 80ml, the class spherical envelope of three kinds of specifications of 40ml can satisfy the patient's of all ages and classes section needs.

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