CN107348933B - Auxiliary operation device for brain hematoma drilling drainage operation endoscope and endoscope - Google Patents

Auxiliary operation device for brain hematoma drilling drainage operation endoscope and endoscope Download PDF

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Publication number
CN107348933B
CN107348933B CN201710666678.7A CN201710666678A CN107348933B CN 107348933 B CN107348933 B CN 107348933B CN 201710666678 A CN201710666678 A CN 201710666678A CN 107348933 B CN107348933 B CN 107348933B
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endoscope
skull
operation device
auxiliary
space
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CN107348933A (en
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何超
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/012Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
    • A61B1/018Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064Constructional details of the endoscope body
    • A61B1/00071Insertion part of the endoscope body
    • A61B1/0008Insertion part of the endoscope body characterised by distal tip features
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00131Accessories for endoscopes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/313Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes

Abstract

The invention discloses an auxiliary operation device for a cerebral hematoma drilling drainage operation endoscope and an endoscope, and relates to the field of cerebral neurosurgery. The invention allows the operation to be performed visually while further reducing trauma to the patient.

Description

Auxiliary operation device for brain hematoma drilling drainage operation endoscope and endoscope
[ field of technology ]
The invention relates to the field of cerebral neurosurgery, in particular to an auxiliary operation device for an endoscope for cerebral hematoma drilling drainage operation.
[ background Art ]
The hypertensive cerebral hemorrhage is also called cerebral hemorrhage or hemorrhagic stroke, and refers to the occurrence of hemorrhage in brain parenchyma under the condition of hypertension, and is the occurrence of cerebral hemorrhage caused by cerebrovascular disease due to hypertension. The common treatment means for the existing hypertension cerebral hemorrhage are as follows: bone flap decompression craniotomy hematoma removal, microhematoma removal with small bone window and drainage, neuroendoscopic minimally invasive surgery and craniotomy tube hematoma aspiration (stereotactic + -fibrinolysis).
With the increasing clinical experience, most neurosurgeons have realized that traditional debridement, decompression, craniotomy, hematoma removal procedures treat cerebral hemorrhage with the resulting trauma of the procedure being too great or even having to be tasted lost. Microhole microsurgery (microhole plus endoscope, microhole plus drainage) is currently widely used for treating cerebral hemorrhage, but is still more traumatic and has more complications compared with minimally invasive tube hematoma removal from the aspect of treatment. Craniotomy keyhole surgery is also used for the treatment of cerebral hemorrhage, but the instrument conditions and technical requirements are relatively high. In general, surgical (open) treatment of cerebral hemorrhage can reduce the mortality and disability rate, while it is not beneficial for deep hematomas and thalamus hemorrhage. No matter how "minimally invasive" the craniotomy is, it is a relatively large damage to the brain tissue and body of the patient, which largely counteracts the benefits of removing hematoma. On the other hand, the microscope operation treatment needs craniotomy, so that the patient needs general anesthesia, the operation time is long, the operation risk is high, and the patient needs to bear sequelae caused by general anesthesia. In addition, microscopic surgical equipment is expensive to purchase, resulting in high surgical costs.
Minimally invasive neurosurgical procedures are performed entirely endoscopically, requiring the use of specialized endoscopic instruments to perform the procedure through the endoscopic lumen channel. Due to the limitation of the size of the inner diameter instrument, the caliber of the endoscope lumen channel is about two to three centimeters at minimum. The artificial channel can cause a certain damage to brain tissues of a patient, so that peripheral edema and nerve damage of the channel are caused, and recovery of brain functions is affected. Meanwhile, as the endoscope lumen channels are all disposable medical supplies, the price is high, and the operation cost is high.
Various directional cranium catheterization hematoma suction techniques adopted by neurosurgeons are to puncture the cranium using a metal tool under blind vision. The operation under blind vision is based on the technical experience and the on-site judgment of the doctor of the main knife, so that the risk of meninges bleeding and cerebral cortex cerebral vascular bleeding caused by the puncturing of the meninges is greatly increased, and the technical safety of the cerebral and the meninges is not ensured.
[ invention ]
In order to solve the problems, the invention provides an auxiliary operation device for an endoscope for cerebral hematoma drilling drainage operation, which enables the operation to be operated under a visual condition and simultaneously further reduces the trauma to a patient.
In order to achieve the above purpose, the invention adopts the following technical scheme:
an auxiliary operating device for an endoscope for brain hematoma drilling drainage surgery, the auxiliary operating device comprising: a mounting portion for mounting the auxiliary operation device to the endoscope; an extension portion extending into the cranial canal; the connecting part is used for connecting the mounting part and the extending part, the connecting part is opened to form an operation space, and the surgical instrument extends into the skull duct from the operation space.
Further, the connecting portion and the extending portion are arc-shaped plates, and the operation space is formed in a region corresponding to the concave surface of each arc-shaped plate.
Optionally, the connecting portion and the extending portion are straight plates, and one side of each straight plate forms the operation space.
Optionally, the connecting part is a tubular part, an opening is formed in the side wall of the tubular part, and the interior of the tubular part and the opening form the operation space.
Optionally, the connection portion includes a plurality of plate-like members, the plurality of plate-like members being spaced apart, and the space between the inner sides of the plurality of plate-like members and the plate-like members forming the operation space.
In addition, the invention also discloses an endoscope, which comprises an endoscope body and a cover body for wrapping the endoscope body, wherein the endoscope further comprises any one of the auxiliary operation devices, and the connecting part of the auxiliary operation device is connected with the cover body.
After the technical scheme is adopted, the invention has the following advantages:
an auxiliary operating device for an endoscope for brain hematoma drilling drainage surgery, the auxiliary operating device comprising: a mounting portion for mounting the auxiliary operation device to the endoscope; an extension portion extending into the cranial canal; the connecting part is used for connecting the mounting part and the extending part, the connecting part is opened to form an operation space, and the surgical instrument extends into the skull duct from the operation space: the mounting portion mounts the auxiliary operation device to a lens of the endoscope. The opening of the connecting part forms an operation space, which is the area formed by the opening of the connecting part between the upper part of the skull duct and the endoscope mirror surface. The angle direction of the instrument tool used in the operation can be randomly changed without any limitation outside the skull, and the instrument tool used in the operation can randomly change the angle direction outside the skull without any limitation because the connecting part is open, and the instrument tool enters the skull duct through the operation space to treat the focus part in the skull duct. This removes the restriction of the size of the tool used in the operation on the lumen channel of the endoscope, and the size of the skull canal can be further reduced to about 5mm to 7mm, which further reduces the trauma suffered by the patient. The small incision has smaller scar left after operation, the influence on the appearance of the patient after the operation is finished is minimized, and compared with the larger scar left after the conventional operation, the patient is subjectively more acceptable. The space required for treating the focus part is provided by the extending part and the hole wall of the skull hole, so that a channel is not required to be artificially constructed, and the damage to brain tissues is avoided. The extending part extends into the skull duct and is always in contact with the meninges, so that a doctor of the main knife does not need to hang in the air, and the operation control of the doctor of the main knife is facilitated. In addition, the endoscope enables the whole operation not to be blind operation, reduces the operation difficulty, avoids meningeal hemorrhage and cerebral cortex cerebral vascular hemorrhage caused by puncturing the meninges in the operation process, and ensures the operation safety. Meanwhile, the connecting part and the extending part play a role in guiding light emitted by the light source of the endoscope, so that the light is better gathered in the skull duct, the definition in the skull duct is improved, and a doctor of a main knife can better observe the conditions of the distribution of blood vessels in the skull duct, the surfaces of the meninges and the cerebral cortex. The auxiliary operation device has simple structure and low cost, greatly reduces the operation cost and lightens the economic burden of patients. Meanwhile, the operation can be performed in a local anesthesia mode, and the patient does not need to bear sequelae caused by general anesthesia.
The connecting part and the extending part are arc-shaped plates, and the area corresponding to the concave surface of each arc-shaped plate forms the operation space: the arc plate stretches into the skull canal, and the arc plate is concave, so that the space for operating the instrument and tool to move in the skull canal is larger.
The connecting part is a cylindrical part, an opening is formed in the side wall of the cylindrical part, and the interior of the cylindrical part and the opening form the operation space: the opening and the tubular part form an operation space, so that not only can the angle direction of an instrument used in operation be changed at will without any limitation outside the skull, but also the operation space can be used for entering the skull duct to treat the lesion parts in the skull duct and in front of the skull duct, and the skull, the meninges, the brain tissues and the blood vessels can be better protected.
The connecting part comprises a plurality of plate-shaped parts, the plate-shaped parts are distributed at intervals, and the operating space is formed by the intervals between the inner sides of the plate-shaped parts and the plate-shaped parts: providing more abundant operation space for more complex operation, and the instruments and tools used for the operation have more action scope.
The doctor of the main knife can flexibly select the auxiliary operation device in various modes according to the operation difficulty, the operation requirement and the like, so that the auxiliary operation device is more matched with the operation environment, and the smooth operation is ensured.
The invention also discloses an endoscope, which comprises an endoscope body and a cover body for wrapping the endoscope body, and the endoscope further comprises any auxiliary operation device, wherein the connecting part of the auxiliary operation device is connected with the cover body. The beneficial effects achieved by the endoscope are the same as those achieved by the auxiliary operation device described above, and the deduction process is similar to that achieved by the auxiliary operation device, so that the description is omitted here.
These features and advantages of the present invention will be disclosed in more detail in the following detailed description and the accompanying drawings. The best mode or means of the present invention will be described in detail with reference to the accompanying drawings, but is not limited to the technical scheme of the present invention. In addition, these features, elements, and components are shown in plural in each of the following and drawings, and are labeled with different symbols or numerals for convenience of description, but each denote a component of the same or similar construction or function.
[ description of the drawings ]
The invention is further described below with reference to the accompanying drawings:
FIG. 1 is a schematic illustration of a first embodiment of the present invention;
FIG. 2 is a schematic operation of a first embodiment of the present invention;
FIG. 3 is a schematic diagram of a second embodiment of the present invention;
FIG. 4 is a schematic diagram of a third embodiment of the invention;
FIG. 5 is a schematic diagram of a fourth embodiment of the invention;
fig. 6 is a schematic diagram of a fifth embodiment of the present invention.
In the accompanying drawings:
1-auxiliary operation device, 1.1-installation part, 1.2-connection part, 1.3-extension part, 2.1-installation part, 2.2-connection part, 2.3-extension part, 3.1-installation part, 3.2-connection part, 3.3-extension part, 3.4-opening, 4.1-installation part, 4.2-connection part, 4.3-extension part, 5-endoscope, 6-skull, 7-focus part, 8-operation space, 9-scope cover, 10-handle cover, 11-display screen cover, 12-cover body.
[ detailed description ] of the invention
The technical solutions of the embodiments of the present invention will be explained and illustrated below with reference to the drawings of the embodiments of the present invention, but the following embodiments are only preferred embodiments of the present invention, and not all embodiments. Based on the examples in the implementation manner, other examples obtained by a person skilled in the art without making creative efforts fall within the protection scope of the present invention.
Reference in the specification to "one embodiment" or "an example" means that a particular feature, structure, or characteristic described in connection with the embodiment itself can be included in at least one embodiment of the present patent disclosure. The appearances of the phrase "in one embodiment" in various places in the specification are not necessarily all referring to the same embodiment.
In the description of the embodiments of the present invention, the terms "upper", "lower", "left", "right", "lateral", "longitudinal", "inner", "outer", and the like indicate an azimuth or a positional relationship based on the azimuth or the positional relationship shown in the drawings, which are merely for convenience of description of the present invention and do not require that the present invention must be constructed and operated in a specific azimuth, and thus should not be construed as limiting the present invention.
Embodiment one:
the embodiment provides an auxiliary operation device for an endoscope for cerebral hematoma drilling drainage operation. As shown in fig. 1 and 2, the auxiliary operation device 1 for an endoscope for cerebral hematoma drilling drainage surgery includes a mounting portion 1.1, a connecting portion 1.2, and an extending portion 1.3. The mounting portion 1.1 is annular and is sleeved on the lens portion of the endoscope 5, and is used for mounting the auxiliary operation device 1 to the endoscope 5, the mounting portion 1.1 can also be provided in a shape that the side wall is provided with an axial opening, and the lens portion of the endoscope 5 is clamped. The connecting part 1.2 and the extending part 1.3 are arc-shaped plates, and the axial direction of the arc-shaped plates is along the axial direction of the mounting part 1.1. The installation department 1.1, connecting portion 1.2 and stretch into portion 1.3 integrated into one piece setting, length is 2cm to 3cm, and the terminal surface that connecting portion 1.2 was close to installation portion 1.1 is 120 contained angles with the axial of connecting portion 1.2. The auxiliary operation device 1 is arranged on the lens part of the endoscope 5, the focus part 7 is arranged on the inner side of the skull 6, the skull 6 is drilled above the focus part 7, the endoscope 5 is connected with the auxiliary operation device 1 to extend the extension part 1.3 into the skull duct, the extension part 1.3 is contacted with the meninges, and the operation space 8 is formed in the area corresponding to the concave surface of the connecting part 1.2. The auxiliary operation device 1 is made of medical grade plastic material and is disposable.
Since the arc is open, the instrument tool used in the operation can be freely changed in angle direction outside the skull 6 without any limitation, and can enter the skull canal through the operation space 8 for treatment operation. This frees the scope lumen channel from the size of the instrument used in the procedure, and therefore the size of the cranial canal can be further reduced to about 5mm to 7mm, which further reduces the trauma suffered by the patient. The extension part 1.3 extends into the skull duct, and the space required for treating the focus part 7 is provided by the concave surface of the extension part 1.3 and the wall of the skull duct, so that a channel is not required to be artificially constructed, and the damage to the brain is avoided. The extension part 1.3 extends into the skull duct and keeps contact with the meninges all the time, so that a doctor of the main knife does not need to hang in the air, and the operation control of the doctor of the main knife is facilitated. In order to avoid damage to brain tissue caused by the edge of the protruding part 1.3 when the protruding part 1.3 is kept in contact with the meninges, the edge of the protruding part 1.3 is subjected to passivation treatment, and the edge of the protruding part 1.3 is treated to form an obtuse angle or a round angle. The endoscope 5 makes the whole operation not be blind operation, reduces the operation difficulty, and avoids meningeal hemorrhage and cerebral cortex cerebral vascular hemorrhage caused by puncturing the meninges. The end face of the mounting part 1.1, which is close to the connecting part 1.2, forms an included angle of 120 degrees with the axial direction of the connecting part 1.2, so that the observation field of view of the endoscope 5 is enlarged, and the operation space 8 is expanded, so that the instrument used in the operation has more abundant space to enter the skull duct. The connecting part 1.2 and the extending part 1.3 are integrally formed and arranged, so that light emitted by a light source of the endoscope 5 is guided, the light is better concentrated in the skull duct, the definition in the skull duct is improved, and a doctor of a main knife can better observe the condition in the skull duct. The auxiliary operation device 1 is made of medical grade plastic materials, has simple structure and low manufacturing cost, greatly reduces the operation cost and lightens the economic burden of patients. Meanwhile, as the skull 6 is drilled only above the focus part 7, the operation can be performed in a local anesthesia mode, and the patient does not need to bear sequelae caused by general anesthesia.
Embodiment two:
as shown in fig. 3, the second embodiment is modified based on the first embodiment, and is different from the first embodiment in that the connecting portion 2.2 and the extending portion 2.3 in the second embodiment are straight plates, the mounting portion 2.1, the connecting portion 2.2 and the extending portion 2.3 are integrally formed, an included angle of 120 ° is formed between an end surface of the mounting portion 2.1, which is close to the connecting portion 2.2, and an operation space is formed on a side, which is oriented by the included angle of 120 ° of the connecting portion 2.2.
Embodiment III:
as shown in fig. 4, the third embodiment is modified from the first embodiment, and is different from the first embodiment in that the connecting portion 3.2 and the extending portion 3.3 in the third embodiment are tubular members, the mounting portion 3.1, the connecting portion 3.2 and the extending portion 3.3 are integrally formed, an opening 3.4 is provided in a side wall of the tubular member, and an operation space is formed between the interior of the tubular member and the opening 3.4. The opening 3.4 and the inner part of the tubular part form an operation space, thereby not only meeting the requirement that the instrument used in the operation can randomly change the angle direction outside the skull without any limitation, but also ensuring that the skull, the meninges, the brain tissues and the blood vessels can be better protected when the operation space enters into the skull duct to treat the lesion parts in and in front of the skull duct.
Embodiment four:
as shown in fig. 5, the fourth embodiment is modified based on the first embodiment, unlike the first embodiment, in the fourth embodiment, the connecting portion 4.4 and the extending portion 4.3 are two plate-shaped members which are oppositely arranged, the mounting portion 4.1, the connecting portion 4.2 and the extending portion 4.3 are integrally formed, an included angle of 120 ° is formed between an end surface of the mounting portion 4.1, which is close to the connecting portion 4.2, and an axial direction of the connecting portion 4.2, an operation space is formed by opposite regions of the two plate-shaped members, and an instrument used in an operation enters the operation space from a side which is oriented by the included angle of 120 °. The fourth embodiment provides more abundant operation space for more complex operation, and the instruments and tools used for the operation have more action scope.
Fifth embodiment:
the present embodiment provides an endoscope, as shown in fig. 6, including an endoscope body and a cover body 12 for wrapping the endoscope body, the cover body 12 includes a scope cover 9, a handle cover 10 and a display screen cover 11, the scope cover 9 is used for wrapping a scope of the endoscope, the handle cover 10 is used for wrapping a handle of the endoscope, the display screen cover 11 is used for wrapping a display screen of the endoscope, the endoscope further includes the auxiliary operation device 1 in embodiment one, the auxiliary operation device 1 includes a mounting portion 1.1, a connecting portion 1.2 and a projecting portion 1.3, and the connecting portion 1.1 is connected to an end portion of the scope cover 9.
The above is only a specific embodiment of the present invention, but the scope of the present invention is not limited thereto, and it should be understood by those skilled in the art that the present invention includes but is not limited to the accompanying drawings and the description of the above specific embodiment. Any modifications which do not depart from the functional and structural principles of the present invention are intended to be included within the scope of the appended claims.

Claims (5)

1. A auxiliary operation device for brain hematoma drilling drainage operation endoscope, its characterized in that: the auxiliary operating means may comprise a control unit,
a mounting part for mounting the auxiliary operation device to the endoscope, wherein the mounting part is annular and sleeved at the lens part of the endoscope;
the extension part extends into the skull drill hole, the extension part is kept in contact with the meninges, the edge of the extension part is an obtuse angle or a round angle, and the extension part and the hole wall of the skull hole channel provide a space required for treating a focus part;
the connecting part is used for connecting the mounting part and the extending part, the connecting part is opened to form an operation space, the operation space is an area formed by opening the connecting part between the upper part of the skull duct and the mirror surface of the endoscope, so that an instrument tool used in operation can randomly change the angle direction outside the skull without any limitation, and enters the skull duct through the operation space to treat a focus part in the skull duct, the connecting part comprises a plurality of plate-shaped parts, the plate-shaped parts are distributed at intervals, and the operation space is formed by the inner sides of the plate-shaped parts and the plate-shaped parts;
the installation part, the connecting part and the extending part are integrally formed, the length is 2cm to 3cm, and the end face of the installation part, which is close to the connecting part, forms an included angle of 120 degrees with the axial direction of the connecting part;
from the operating space, the surgical instrument protrudes into the skull borehole.
2. The auxiliary operation device according to claim 1, wherein: the connecting part and the extending part are arc-shaped plates, and the area corresponding to the concave surface of each arc-shaped plate forms the operation space.
3. The auxiliary operation device according to claim 1, wherein: the connecting part and the extending part are straight plates, and one side of each straight plate forms the operation space.
4. The auxiliary operation device according to claim 1, wherein: the connecting part is a cylindrical part, an opening is arranged on the side wall of the cylindrical part, and the interior of the cylindrical part and the opening form the operation space.
5. An endoscope comprising an endoscope body and a cover for wrapping the endoscope body, characterized in that the endoscope further comprises the auxiliary operation device according to any one of claims 1 to 4, a connecting portion of the auxiliary operation device being connected to the cover.
CN201710666678.7A 2017-08-07 2017-08-07 Auxiliary operation device for brain hematoma drilling drainage operation endoscope and endoscope Active CN107348933B (en)

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CN107348933B true CN107348933B (en) 2023-12-05

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CN115067859A (en) * 2022-06-20 2022-09-20 上海宇度医学科技股份有限公司 Endoscope intubation assembly and endoscope

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CN102958457A (en) * 2010-06-30 2013-03-06 泰尔茂株式会社 Medical device
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CN208319176U (en) * 2017-08-07 2019-01-04 何超 Backup actuating device and endoscope for cephalophyma trepanation and drainage operation endoscope

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WO2011024901A1 (en) * 2009-08-26 2011-03-03 国立大学法人大阪大学 Endoscope insertion aid
CN102958457A (en) * 2010-06-30 2013-03-06 泰尔茂株式会社 Medical device
CN205672283U (en) * 2016-04-28 2016-11-09 重庆市江津区中心医院 Bone hole holder and drainage component
CN208319176U (en) * 2017-08-07 2019-01-04 何超 Backup actuating device and endoscope for cephalophyma trepanation and drainage operation endoscope

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