CN102085108B

CN102085108B - Minimally invasive surgical instrument for Achilles tendon

Info

Publication number: CN102085108B
Application number: CN201110004895.2A
Authority: CN
Inventors: 曲巍
Original assignee: Individual
Current assignee: Individual
Priority date: 2011-01-11
Filing date: 2011-01-11
Publication date: 2015-02-04
Anticipated expiration: 2031-01-11
Also published as: CN102085108A

Abstract

The invention provides a minimally invasive surgical instrument for Achilles tendon, capable of reducing wound, reducing complication and ensuring the suture quality by a minimally invasive operation with a minimal incision. The minimally invasive surgical instrument comprises a needle with an absorbable suture line, a curved awl-shaped Achilles tendon opener and a pilot sleeve, wherein the inner circle of one end of the pilot sleeve is matched with the curved awl tip of the Achilles tendon opener, one end of the pilot sleeve is sleeved on the curved awl tip of the Achilles tendon opener and penetrates through an opening along with the withdrawing process of the curved awl tip of the Achilles tendon opener, and then the needle with the absorbable suture line penetrates through the pilot sleeve and leads the suture line to penetrate through a curved threading hole of the Achilles tendon for suturing. Only a minimal incision is formed on the skin of the Achilles tendon, and the surgical treatment ensures the repair quality of the Achilles tendon, reduces the recurrent rupture rate, causes smaller injury than an open surgery, and avoids complications such as necrosis of skin and the like.

Description

Heel string Minimally Invasive Surgery utensil

Technical field: heel string Minimally Invasive Surgery utensil is utensil rupture of Achilles tendon being carried out to suture operation, particularly takes minimal incision * Minimally Invasive Surgery to carry out sewing up the surgical instrument of docking heel string.

Background technology: rupture of Achilles tendon is a kind of common athletic injury.The incidence rate that expectant treatment heel string ruptures again is high.Open surgery sutural treatment can ensure the repairing quality of heel string, reduces the incidence rate that ruptures again, and utensil used is exactly the utensil such as the conventional suture of existing operation and pliers tweezers.But, open surgery damage comparatively large (see attached circle 1).Easily there is the complication such as cutaneous necrosis.If adopt minimal incision * Minimally Invasive Surgery to reduce wound, reduce complication, but adopt existing utensil to operate.

Summary of the invention:

The present invention solves exactly and can reduce wound to employing minimal incision * Minimally Invasive Surgery, reduces complication, but cannot operate, can not ensure the problem of suture quality, provide a kind of heel string Minimally Invasive Surgery utensil.

In order to solve the problem, heel string Minimally Invasive Surgery utensil of the present invention, the pin containing band Absorbable rod astragal, is characterized in that: also have curved tapered heel string gag and pilot sleeve.The curved cone tip of pilot sleeve one end inner circle and heel string gag matches, one end of pilot sleeve is enclosed within the curved cone tip of heel string gag, the curved cone tip of following heel string gag is exited process and passes opening, again the pin of band Absorbable rod astragal is passed pilot sleeve, guide the bending through wires hole passing the suture through heel string.Like this, as long as also have osculum at the fracture heel string both end sides surface skin that will sew up, with curved tapered heel string gag, curved tapered tip is inserted from heel string side and stretches out from another side, position again, form the opening of bending through hole.When bending through hole from heel string and exiting curved tapered heel string gag, be enclosed within curved tapered tip with pilot sleeve one end, pilot sleeve is followed the opening following that curved tapered tip enters heel string and is stretched from the side of opening.Pilot sleeve is through opening, through opening convenient the passing in pilot sleeve of pin with band Absorbable rod astragal, extracts pilot sleeve, just defines the basic process that needle thread passing heel string carries out sewing up.Under so just can only having the prerequisite of osculum, adopt various sewing method, try to make a match between the heel string disconnected, carry out various skill and technique cableties sewing process.

Compared with the prior art the present invention, has advantage as follows: heel string Minimally Invasive Surgery utensil of the present invention not only makes minimal incision * Minimally Invasive Surgery be able to effective enforcement, can reduce wound, reduces complication.Also make the operation of minimal incision * Minimally Invasive Surgery be very easy to conveniently simultaneously, be easy to ensure suture quality.。

Accompanying drawing illustrates: drawings illustrate a kind of heel string Minimally Invasive Surgery utensil structure schematic diagram of the present invention and carry out the schematic diagram of use procedure of performing the operation.Wherein, Fig. 1 is the pilot sleeve schematic diagram of heel string Minimally Invasive Surgery utensil, Fig. 2 is Absorbable rod astragal No. 1 staight needle schematic diagram of heel string Minimally Invasive Surgery utensil, and Fig. 3 is Absorbable rod astragal No. 2 staight needle schematic diagrams of heel string Minimally Invasive Surgery utensil, and Fig. 4 is the heel string gag schematic diagram of heel string Minimally Invasive Surgery utensil; Fig. 5 is the schematic diagram of rupture of Achilles tendon, Fig. 6 is the schematic diagram that in prior art, heel string opening operation greatly enhances otch, Fig. 7 is the schematic diagram that heel string Minimally Invasive Surgery of the present invention opens osculum, the schematic diagram of Fig. 8 to be heel string Minimally Invasive Surgery of the present invention by driving minimal incision * place heel string gag formed at heel string opening of trying to make a match, Fig. 9 is that heel string Minimally Invasive Surgery of the present invention guides pilot sleeve to be passed in the schematic diagram that heel string forms the opening of trying to make a match by driving minimal incision * place heel string gag, Figure 10 is that heel string Minimally Invasive Surgery of the present invention is passed in the schematic diagram of trying to make a match after heel string forms the opening of trying to make a match by driving minimal incision * place pilot sleeve, to be heel string Minimally Invasive Surgery of the present invention be in by opening minimal incision * the schematic diagram that heel string opening tries to make a match to Figure 11, Figure 13 is that heel string Minimally Invasive Surgery of the present invention is in by opening minimal incision * the schematic diagram forming lasso method process after heel string opening is tried to make a match, Figure 14 be heel string Minimally Invasive Surgery of the present invention by open minimal incision * be in heel string form lasso method after again with the pin upwards heel string section schematic diagram of trying to make a match, Figure 15 is the schematic diagram after heel string Minimally Invasive Surgery of the present invention tries to make a match out by heel string section part minimal incision * place, Figure 16 be heel string Minimally Invasive Surgery of the present invention by heel string section part minimal incision * place upwards near-end heel string try to make a match and pass the schematic diagram of process from heel string belly of muscle minimal incision *, Figure 17 be heel string Minimally Invasive Surgery of the present invention by heel string section part minimal incision * place upwards near-end heel string try to make a match and schematic diagram after passing from heel string belly of muscle minimal incision *, to be heel string Minimally Invasive Surgery of the present invention also complete upwards near-end heel string by minimal incision * at heel string opposite side to Figure 18 tries to make a match and schematic diagram after passing tension from heel string belly of muscle minimal incision *, Figure 19 is that heel string Minimally Invasive Surgery of the present invention forms the schematic diagram of the opening of trying to make a match by minimal incision * place heel string gag on the left of near-end heel string, Figure 20 is that heel string Minimally Invasive Surgery of the present invention guides pilot sleeve through the schematic diagram of opening on the left of near-end heel string by minimal incision * place heel string gag, Figure 21 is the schematic diagram of trying to make a match after heel string Minimally Invasive Surgery of the present invention passes near-end heel string opening by minimal incision * place pilot sleeve, to be heel string Minimally Invasive Surgery of the present invention be in opening on the left of near-end heel string by minimal incision * to Figure 22 tries to make a match and the schematic diagram cutting off line process after forming lasso, to be heel string Minimally Invasive Surgery of the present invention be in near-end heel string right openings by minimal incision * to Figure 23 tries to make a match and cut off line schematic diagram after forming lasso, Figure 23 tries to make a match the heel string both sides that to be heel string Minimally Invasive Surgery of the present invention be in fracture by minimal incision * the schematic diagram after sewing up.Example below in conjunction with accompanying drawing further illustrates.

Detailed description of the invention:

This heel string Minimally Invasive Surgery utensil of the present invention as shown in drawings, the pin containing band Absorbable rod astragal, is characterized in that: also have curved tapered heel string gag, guide the pilot sleeve of trying to make a match in addition.Specifically, heel string Minimally Invasive Surgery utensil of the present invention divides three parts, the curved cone of most advanced and sophisticated 1/4 arc and the heel string gag (Fig. 4) being connected handle and forming, the tip of one end and heel string gag coincide the other end with bell mouth shape pilot sleeve (Fig. 1), No. 1 staight needle (Fig. 2) with Absorbable rod astragal and No. 2 pin staight needles (Fig. 3) with Absorbable rod astragal.

Heel string Minimally Invasive Surgery utensil of the present invention is used to carry out Minimally Invasive Surgery method: heel string is sewed up the skill of handling needles and adopted lasso method (Tsuge method), and patient ventricumbent position, first takes epidural anesthesia to patient.

Method one: utilize No. 1 staight needle

Above heel string stop, a long 1cm minimal incision * is cut at 2cm place.Cut skin and subcutaneous and identify paratenon, heel string side (see Fig. 8) is inserted by minimal incision * with the curved cone of the most advanced and sophisticated arcuation of heel string gag leading portion, and insert out with miter angle opposite side of being separated by, the opening of trying to make a match is formed (with heel string cross section for dial is located at heel string, the entrance of minimal incision * position is 12 points, outlet is 9 points, forms bending through hole).When the opening of the bending through hole from heel string exits the curved cone of heel string gag, the curved cone most advanced and sophisticated (see Fig. 9) of heel string gag is enclosed within pilot sleeve one end, it is most advanced and sophisticated that the curved cone of arcuation followed by pilot sleeve, enters from the outlet of 9, and follow and stretch from the entrance of opening 12.Such pilot sleeve is through the opening of heel string, then with convenient the passing in pilot sleeve of No. 1 pin of band Absorbable rod astragal through the opening (see Figure 10) of bending through hole, guides No. 1 pin to penetrate and pass heel string.After guiding No. 1 pin to penetrate to pass heel string opening, extract pilot sleeve from heel string opening.No. 1 pin, through heel string opening (Figure 11), is sewed up (Figure 12) with lasso method (Tsuge method) lasso and tightens up, and forms toe-in.No. 1 suture needle penetrates heel string (Figure 13) and partially passes in outside at the heel string broken ends of fractured bone above this first toe-in.Cut the long otch of a long 1cm in heel string broken ends of fractured bone place cortex, insert the guiding of sleeve horn mouth and pass suture needle, the flared end of available pilot sleeve guides No. 1 needle point to pass the cortex minimal incision * (Figure 14,15) of rupture of Achilles tendon place.Sew up the position that near-end heel string is corresponding, the flared end of available pilot sleeve guides No. 1 needle point to pass the cortex minimal incision * (Figure 16,17) of near-end heel string side simultaneously.Repeat above-mentioned steps, in heel string symmetric position, penetrate second piece with No. 1 pin of another band Absorbable rod astragal in heel string opposite side by same maneuver (position is entrance 12 point, exports 3 points) and sew up heel string suture needle (see Figure 18), simultaneously flexing knee joint plantar flexion ankle joint, tightens up two cover astragals.The position heel string gag corresponding in near-end heel string both sides, curved tapered tip is inserted from heel string side and stretches out that (side position is entrance 12 point, exports 9 points again from another side, position, opposite side position is entrance 12 point, exports 3 points), form the opening (see Figure 19) of bending through hole respectively.Same pilot sleeve one end is enclosed within curved tapered tip (Figure 20), pilot sleeve is followed the opening following that curved tapered tip enters heel string and is stretched from the side of opening, and respectively respective No. 1 pin is passed the opening (Figure 21) of heel string through pilot sleeve, sew up (Figure 12) with lasso method (Tsuge method) lasso and tighten up, formed toe-in, and can cut off more than absorption astragal (see Figure 22,23,24).For making the involutory satisfaction more of heel string, 8 words can be added at heel string broken ends of fractured bone incision 2-0 absorbable thread and sewing up.

Method two: utilize No. 2 staight needles

This method only opens two minimal incision *, and above heel string stop, a long 1cm minimal incision * (the lower end minimal incision * see Fig. 7) is cut at 2cm place.Cut skin and subcutaneous and identify paratenon, insert heel string (be 12 points see Fig. 8 entrance, outlet is 9 points) with heel string gag (arcuation is most advanced and sophisticated).Insert pilot sleeve, heel string sewing needle is inserted sleeve, guide suture needle to pass heel string (see Fig. 9,10).Lasso method lasso is sewed up and is tightened up (see Figure 11,12,13).(with method one).Suture needle penetrates heel string above first toe-in, to reset outward the two heel string broken ends of fractured bone in skin with hands, makes staight needle pass the broken ends of fractured bone and to go directly heel string belly of muscle intersection.

Cut a long 1cm osculum at heel string tendon abdomen intersection, be second minimal incision * (minimal incision * see Fig. 7 upper end), appear heel string aponeurosis (aponeuroses), insert sleeve horn mouth respectively and draw 2 pieces of heel string sewing needles (see Figure 18).Simultaneously flexing knee joint plantar flexion ankle joint, tightens up two cover astragals, and makes lasso method (Tsuge method) and sew up (see Figure 19,20,21, with method one).

Adopt heel string Minimally Invasive Surgery utensil of the present invention, the operative treatment carrying out minimal incision * not only can ensure the repairing quality of heel string, reduces the incidence rate that ruptures again, and also little than open surgery damage, there will not be the complication such as cutaneous necrosis, effect is satisfactory.

Claims

1. a heel string Minimally Invasive Surgery utensil, has the staight needle of band Absorbable rod astragal, it is characterized in that: also have curved tapered heel string gag and pilot sleeve, the curved cone tip of pilot sleeve one end inner circle and heel string gag matches; One end of pilot sleeve is enclosed within the curved cone tip of heel string gag, and the curved cone tip of following heel string gag is exited process and passes opening, then the staight needle of Absorbable rod astragal will be with through pilot sleeve, guides Absorbable rod astragal to pass the bending through wires hole of heel string.

2. heel string Minimally Invasive Surgery utensil as claimed in claim 1, is characterized in that: pilot sleeve end is bell mouth shape.

3. heel string Minimally Invasive Surgery utensil as said in claim 1 or 2, is characterized in that: described curved tapered heel string gag, and back segment is cone handle, and leading portion tip is the curved of 1/4 arc.