CN103429178A - 用于在关节镜手术期间使用的装置和方法 - Google Patents

用于在关节镜手术期间使用的装置和方法 Download PDF

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CN103429178A
CN103429178A CN2011800464814A CN201180046481A CN103429178A CN 103429178 A CN103429178 A CN 103429178A CN 2011800464814 A CN2011800464814 A CN 2011800464814A CN 201180046481 A CN201180046481 A CN 201180046481A CN 103429178 A CN103429178 A CN 103429178A
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徳里克·H·奥齐亚尔
保罗·亚历山大·托里
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B17/3209—Incision instruments
    • A61B17/3211—Surgical scalpels, knives; Accessories therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22038—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22038—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
    • A61B2017/22039—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire eccentric
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B2017/320052—Guides for cutting instruments

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Abstract

本公开涉及在关节镜手术期间使用的方法。该方法包括将插管针插入身体的关节区域内，将导管线插入穿过针，将针移除，并且通过使用导管线将关节镜刀插入关节区域内。还公开了关节镜刀和其使用的另一种方法。

Description

用于在关节镜手术期间使用的装置和方法
相关申请的交叉引用
本申请是要求美国专利申请US61/386718优先权的PCT国际专利申请，其公开的内容通过引用将其全文并入本文。
技术领域
本公开总体上涉及关节镜手术，并且具体地涉及用于在关节镜手术期间使用的装置和方法。
背景技术
在髋关节镜期间，通常要求医生使用关节镜刀进行切口，这将允许医生获得至髋关节附近区域的通道。例如，刀可以用于将盂缘从髋臼窝分离。在这一过程期间，刀可以用于在关节囊内进行切口。使用刀将盂缘从关节窝分离具有其缺陷，原因在于刀将盂缘脱离的位置在进行切割前并不已知。因此，需要刀并且特别是允许更准确控制刀的使用方法。
发明内容
在一个方面中，本公开涉及在关节镜手术期间使用的方法。该方法包括将插管针插入身体的关节区域内，将导管线插入穿过针，将针移除，并通过使用导管线将关节镜刀插入关节区域内。
在一个实施例中，方法进一步包括使用刀将部分软组织从骨分离，在骨上进行手术，并且将分离的部分软组织重附着至骨。在另一个实施例中，刀包括近端和远端。在又一个实施例中，远端包括刀刃和导管线部件。在再一个实施例中，软组织是盂缘并且骨是关节窝。在又一个进一步的实施例中，通过使用导管线将关节镜刀插入关节区域内的步骤包括将关节镜刀结合至导管线并且将刀插入关节区域内以使得刀的刀刃插在软组织和骨之间。在另一个更进一步的实施例中，将关节镜刀结合至导管线包括将导管线插入通过部件。在一个实施例中，方法进一步包括使用刀以在髋部上进行切口。
在另一个方面中，本公开涉及关节镜刀。刀包括近端和远端，远端包括刀刃和导管线部件。
在一个实施例中，远端是弯曲的。在另一实施例中，导管线部件包括通孔。
在又一个方面中，本公开涉及在关节镜手术期间使用的方法。方法包括将插管针通过第一通道插入身体的关节区域内；将导管线插入穿过针；通过使用导管线将关节镜刀插入关节区域内；并且在包围关节的关节囊中建立切口，切口位于第一通道和第二通道之间。
在一个实施例中，方法进一步包括在插入导管线之后将针移除。在另一个实施例中，方法进一步包括使用刀将部分软组织从骨分离，在骨上进行手术，并且将分离的部分软组织重附着至骨。在又一个实施例中，刀包括近端和远端。在进一步的实施例中，远端包括刀刃和导管线部件。在再一个进一步的实施例中，软组织是盂缘并且骨是关节窝。在又一个进一步的实施例中，通过使用导管线将关节镜刀插入关节区域内的步骤包括将关节镜刀结合至导管线并且将刀插入关节区域内以使得刀的刀刃插在软组织和骨之间。在一个实施例中，将关节镜刀结合至导管线包括将导管线插入通过部件。
本公开的适用性的另外一些方面根据下文提供的详细描述将变得显而易见。应理解详细的描述和特定的示例虽然说明了本公开的优选实施例，但是仅意图用于说明的目的并且不意图用于限定本公开的保护范围。
附图说明
结合至说明书内并且形成说明书一部分的附图描述本公开的实施例并且与书写的说明一起用于说明本公开的原理、特点和特征。在附图中：
图1示出了本公开的关节镜刀的透视图。
图1A示出了图1中刀的远端的分解图。
图2A-2E示出了在关节镜手术期间将软组织从骨分离的方法。
图3示出了髋关节的截面图，同时在关节囊内进行切口。
具体实施方式
下面的优选实施例的描述实质上仅是示例性的而决不意图用于限定本公开、其应用或用途。
如图1和图1A所示，刀10包括近端11和远端12。近端11构造用于由使用者例如医生握持。远端12包括刀刃12a和导管线部件12b，其作用将在下面进一步描述。远端12，特别是刀刃12a可以是弯曲的，如图1和图1A所示。当刀刃12a结合至导管线时使弯曲的远端12将刀刃12a偏压向导管线，如在图2A-2E进一步所示以及如下所述的，这使刀刃12a和导管线之间的叉开量最小化。但是也可使用具有非弯曲远端的刀10。
如上所述，对于刀10的用途之一是将软组织从骨分离。具体地，刀10被用于在髋关节20上的手术中以从关节窝30分离盂缘40，如图2A-2E所示。插管针50沿轨迹A,B之一设置在关节20内，如图2A-2B所示。可以使用其他轨迹。然后，导管线60穿过针50的中空部设置并且针50从关节移除，如图2C和图2D所示。随后，刀10通过使用导管线60插入关节20内。具体地，刀10通过将导管线60插入穿过部件12b的通孔12b’并将刀10沿导管线60滑动并滑入关节20内而结合至导管线60，以使得刀刃12a位于关节窝30和盂缘40之间，如图2E所示。医生操作刀10以将至少部分盂缘40从关节窝30切除，这样做的目的是允许操作需要手术的关节窝30的一部分或多个部分。随后，刀10被移除并且进行关节窝30上的手术。一旦手术完成，通过使用本领域技术人员已知的软组织固定件或其他固定装置，分离的部分盂缘40被重附着至关节窝30。
图3示出了使用刀10在关节囊70中建立切口。关节囊70是包围关节80的厚层软组织，即股骨90的头部91插入关节窝30的区域。该厚层使得难以改变仪器置入关节80内的轨迹。例如，第一仪器（未示出），例如内窥镜，以及第二仪器例如刀10可以都通过使用单独的通道或通路插入穿过关节囊70并进入关节80内。为了使这些仪器的使用减小难度，切口或狭缝可以形成在关节囊70中，其可以连接通道并允许较少地限制仪器的移动。在关节囊70中建立切口的这个方法可以连同上述将软组织从骨分离的方法一起使用。例如，在将部分盂缘40从关节窝30切除之前，刀10可以被插入关节区域80内，如上所述，并且然后用于在刀通道100和内窥镜通道之间建立切口。
为了清楚起见，图3仅示出了髋关节80和刀通道100的截面视图。虽然内窥镜通道通常紧邻刀通道100设置，但是内窥镜通道可以沿关节囊70在允许医生观察手术区域的任何位置形成。通道100还可以用于其他仪器，例如固定件输送装置或在髋关节80上的手术中使用的其他装置。
为了本公开，关节镜刀10由金属材料制成。但是可以使用其他材料。刀10通过本领域技术人员已知的过程制造。另外，刀可以在除了髋关节以外的关节区域中以上述任一方式使用。而且，在在关节囊中进行了的切口可以以其他方式进行。例如，切口不必连接通道。
由于可以对如上参考相应的图示所述的示例性实施例进行各种修改而不脱离本公开的保护范围，因此想要的是包含在前面描述和在附图中所示的所有内容都解释为说明性的而非限制性的。因此本公开的宽度和保护范围不应受到任何上述示例性实施例的限制，而仅根据下面附于本文的权利要求及其等价物限定。

Claims (20)

1.一种在关节镜手术期间使用的方法，包括：
将插管针插入身体的关节区域内；
将导管线插入穿过针；并且
通过使用导管线将关节镜刀插入关节区域内。
2.根据权利要求1所述的方法，进一步包括在插入导管线后移除针。
3.根据权利要求1所述的方法，进一步包括：
使用刀将部分软组织从骨分离；
在骨上进行手术，以及
将分离的部分软组织重附着至骨。
4.根据权利要求1所述的方法，其中刀包括近端和远端。
5.根据权利要求1所述的方法，其中远端包括刀刃和导管线部件。
6.根据权利要求1所述的方法，其中软组织是盂缘并且骨是关节窝。
7.根据权利要求5所述的方法，通过使用导管线将关节镜刀插入关节区域内的步骤包括将关节镜刀结合至导管线并且将刀插入关节区域内以使得刀的刀刃插在软组织和骨之间。
8.根据权利要求7所述的方法，将关节镜刀结合至导管线包括将导管线插入通过部件。
9.一种关节镜刀，包括；
近端和远端，远端包括刀刃和导管线部件。
10.根据权利要求9所述的关节镜刀，其中远端是弯曲的。
11.根据权利要求9所述的关节镜刀，其中导管线部件包括通孔。
12.根据权利要求1所述的方法，进一步包括使用刀以在关节囊上进行切口。
13.一种在关节镜手术期间使用的方法，包括：
将插管针通过第一通道插入身体的关节区域内；
将导管线插入穿过针；
通过使用导管线将关节镜刀插入关节区域内；并且
在包围关节的关节囊中建立切口，切口位于第一通道和第二通道之间。
14.根据权利要求13所述的方法，进一步包括在插入导管线之后将针移除。
15.根据权利要求13所述的方法，进一步包括：
使用刀将部分软组织从骨分离，
在骨上进行手术，并且
将分离的部分软组织重附着至骨。
16.根据权利要求13所述的方法，其中刀包括近端和远端。
17.根据权利要求13所述的方法，其中远端包括刀刃和导管线部件。
18.根据权利要求13所述的方法，其中软组织是盂缘并且骨是关节窝。
19.根据权利要求17所述的方法，其中通过使用导管线将关节镜刀插入关节区域内的步骤包括将关节镜刀结合至导管线并且将刀插入关节区域内以使得刀的刀刃插在软组织和骨之间。
20.根据权利要求19所述的方法，其中将关节镜刀结合至导管线包括将导管线插入通过部件。
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US9192404B2 (en) 2015-11-24
US20120157999A1 (en) 2012-06-21
US9888936B2 (en) 2018-02-13
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US20160228144A1 (en) 2016-08-11
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