CN107397526B - 硬性脊椎内窥镜 - Google Patents
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Abstract
本发明涉及硬性脊椎内窥镜，包括：硬性管，向内窥镜的前端突出；镜头，设置在上述硬性管的内部，与用于观察患部的摄像装置相连接；清洗通道，喷射用于清洗上述患部的清洗水；操作通道，使脊椎手术时需要的辅助设备进入上述患部；以及光纤维，用于照射照明光，上述硬性脊椎内窥镜的特征在于，上述镜头和清洗通道以相互接触的方式紧贴配置在上述硬性管的一侧内周面，上述操作通道包括紧贴于上述硬性管的内周面的第一曲面和连接上述第一曲面的两端的平坦面。
Description
技术领域
本发明涉及硬性脊椎内窥镜，更详细地涉及如下硬性脊椎内窥镜，相比以往使设置在向硬性脊椎内窥镜的前端突出的硬性管的内部的操作通道的断面积放大2倍，从而通过内窥镜可收尾脊椎融合术等脊椎手术的至始至终，由此可使因手术带来的副作用最小化并提高患者的恢复速度。
背景技术
人体的脊椎分为颈椎、胸椎、腰椎和骶椎的4个部分，并全部的25个椎骨以垂直方式连接来起到支撑我们身体中心的柱体作用。
我们常用的像病名一样的“盘(disc)”本来是叫做椎间盘，是连接椎骨之间的结构物，椎间盘由纤维环和髓核构成，是属于椎骨之间存在的关节软骨的一种，负责脊椎的动作和吸收冲击的缓冲作用。
其相应的正确病名为“脊椎间盘突出症”或“髓核突出症”。虽然椎间盘突出症可发生于脊椎的任何部位，但是腰椎部位的椎间盘突出症占据整体的90％以上为最常见，其次为颈椎(8％左右)，胸椎的发生程度只有百万名中一名而非常罕见。因此，通常盘或椎间盘突出症也可意味着腰椎间盘突出症。
腰椎间盘突出常见的最大原因在于腰椎间盘的退行性变化，通常快到20岁到20岁刚出头时期开始发生，并且椎间盘突出症的发生频率在20多岁开始急剧增加直到活动性强的40多岁为止。
作为椎间盘的构成要素的髓核和作为包围髓核周围的坚固的纤维膜的纤维环都发生椎间盘的退行性变化。先是髓核内的水分含量减少且作为纤维质成分的胶原蛋白增加而使像凝胶一样软乎乎的髓核变干燥，从而无法有效吸收椎间盘受到的冲击，而且纤维环的水分也减少并出现裂痕，从而发生脆弱部位。这时，过度的冲击，尤其是同时受到弯曲力和旋转力会导致纤维环破裂使内部的髓核推动纤维轮向外部突出。但是，有时候即使没有受到任何过度的冲击也可发生髓核的突出。即，长时间具有椎间盘的退行性变化而受到若干过度的冲击使纤维环无法再挺住导致被挤出或破裂。
另一方面，人的身体中具有脊髓经过的脊椎管，构成该脊椎管的各种结构物发生变形时使脊椎管变厚。脊椎管的变厚使前后、左右的四方变窄，从而直接挤压脊髓和神经根并发生血流障碍导致出现脊椎狭窄症症状。尤其，随着年龄的增长，脊椎骨之间的韧带变厚，退行性关节炎的严重时，向脊椎管生长如刺状的骨头可使脊椎管空间变窄。因此，与间盘突出不同，跟年龄息息相关且大多在50岁以上非常常见，并且虽然罕见，但先天性的窄脊椎管时也可出现在年轻人身上。
近年来，基于微创手术的手术伤口小、肌肉损伤小、最小化因手术后的副作用、提高患者恢复和康复时间来快速回到日常生活的优点，其通过脊椎内窥镜也广泛应用在脊椎手术。
图1为示出常见的脊椎内窥镜1的图，主要使用向内窥镜前端突出的管由坚固的材质构成的硬性内窥镜。
图2为示出硬性管10的前端的放大图，硬性管10内包括：镜头11，起到可观察患部的摄像装置的窗作用；清洗通道(irrigation channel)12，喷射食盐水等清洗水来清洗患部的血液等来确保视野；操作通道(working channel)13，使手术时需要的手术钳(forcep)或钻孔器等辅助设备进入患部。并且，除了上述镜头11或清洗通道12、操作通道13所占据的空间以外的剩余部分插入有用于照射照明光的光纤维14。
但是，近年来，为了做微创手术而内窥镜的硬性管越来越最小化，因此，操作通道的断面积也变小导致出现难以使用大手术钳或钻孔器等辅助设备的情况。尤其，通过外科手术来治疗脊椎管狭窄症的情况下，如图3所示执行如下的脊椎融合术，剖开手术部位后去除出现退行性变化的骨头、韧带组织、突出的盘，并在去除盘后的空间插入作为盘的替代物的椎间融合器(cage)(参照图4)，随后为使脊椎不会晃动而在脊椎骨打入螺钉来固定。但是，目前的脊椎内窥镜的操作通道极其狭小，导致执行如上所述的脊椎融合术几乎不可能。
结果，即使以微创手术为目的使用脊椎内窥镜来开始手术也时而发生只用内窥镜来手术而无法收尾的情况，并且，发生剖开更长的患部来完成手术导致无法实现微创手术具有的优点的本来目的的问题。
现有技术文献
专利文献1：日本授权实用新型第3176713号(2012年07月05日)
专利文献2：韩国授权专利公报第10-0900991号(2009年06月04日)
发明内容
(一)要解决的技术问题
本发明的目的在于提供硬性脊椎内窥镜，其具有用于微创手术的内窥镜的硬性管日渐最小化的情况下也能只用脊椎内窥镜来手术并可收尾的新结构。
并且，本发明的又一目的在于，提供能够只用脊椎内窥镜不仅可进行及完成简单的椎间盘手术，而且也可进行及完成人工椎间置换术或脊椎融合术等重症椎间盘手术的硬性脊椎内窥镜。
(二)技术方案
本发明涉及硬性脊椎内窥镜，包括：硬性管，向内窥镜的前端突出；镜头，设置在上述硬性管的内部，与用于观察患部的摄像装置相连接；清洗通道，喷射用于清洗上述患部的清洗水；操作通道，使脊椎手术时需要的辅助设备进入上述患部；以及光纤维，用于照射照明光，上述硬性脊椎内窥镜的特征在于，上述镜头和清洗通道以相互接触的方式紧贴配置在上述硬性管的一侧内周面，上述操作通道包括紧贴于上述硬性管的内周面的第一曲面和连接上述第一曲面的两端的平坦面。
优选地，上述第一曲面占据上述硬性管的内周面的70％以上。
上述操作通道的平坦面可与上述镜头和清洗通道中直径最大的外周面相接触。
因此，根据本发明的实施方式的硬性脊椎内窥镜，能够使作为椎间盘替代物的椎间融合器经上述操作通道通过。
(三)有益效果
根据具有如上述结构的硬性脊椎内窥镜，镜头和清洗通道以相互接触的方式紧贴配置于上述硬性管的一侧内周面，从而第一次确保空间来可确保操作通道的最大断面积。
并且，本发明涉及的硬性脊椎内窥镜的操作通道不是以以往的正圆形态，而是具有类似隧道的形态来在限制的硬性管的直径大小中最大限度地提高操作通道，当执行人工椎间盘置换术或脊椎融合术时，可不触碰神经和肌肉并通过操作通道来插入大小最大的椎间融合器，因此，只用脊椎内窥镜可进行及完成重症盘手术来减轻患者对手术的负担并有助于提高手术后恢复速度。
附图说明
图1为示出根据现有技术的硬性脊椎内窥镜的整体外形的图。
图2为示出图1中由“A”表示的硬性管前端的结构的放大图。
图3为简略示出脊椎融合术的手术过程的图。
图4为示出作为椎间盘的人工替代物的椎间融合器的一例的图。
图5为示出设置在本发明的硬性脊椎内窥镜的硬性管前端的结构的放大图。
附图标记的说明
1：硬性脊椎内窥镜，100：硬性管，110：镜头，120：清洗通道，130：操作通道，132：第一曲面，134：平坦面，140：光纤维，CG：椎间融合器
具体实施方式
以下，参照所附的附图来详细说明本发明的优选实施方式。
对本发明的实施方式进行说明的过程中，将省略只要是本发明所属技术领域的普通技术人员就可以理解的公知的结构的说明，以免不必要地混淆本发明的要旨。
本发明涉及硬性脊椎内窥镜1，图5示出了本发明的优选实施方式。
本发明的硬性脊椎内窥镜1也与现有技术类似地包括向内窥镜1的前端突出的硬性管100，并且硬性管100的内部具有镜头110、清洗通道120、操作通道130及光纤维140。即，根据本发明的硬性脊椎内窥镜1的外形与图1中的现有技术几乎类似，但硬性管100的内部结构具有差异，因此，本发明可适用于图1中的硬性脊椎内窥镜1。
镜头110是与用于观察患部的摄像装置相连接的光学窗，清洗通道120是为了清洗患部的血液等来确保视野而喷射食盐水等清洗水的通道。示出的实施方式中，在一个镜头110的两边分别配置有一个直径相对小的清洗通道120，从而可均匀地清洗镜头110的周边。
而且，在硬性管100的内部具有操作通道，其为断面积最大的通道，使脊椎手术时需要的辅助设备，例如，手术钳(forcep)或钻孔器等进入患部，进而，使执行脊椎融合术时替代椎间盘的椎间融合器通过。并且，除了镜头110和清洗通道120、操作通道130所占据的空间以外的其他区域具有用于对患部照射照明光的光纤维140。
适当地设计并配置上述各种通道和镜头110等时，本发明的硬性脊椎内窥镜1中，尤其，镜头110和清洗通道120以相互接触的方式紧贴配置在硬性管100的一侧内周面上，另一方面，操作通道130呈隧道形状，紧贴于硬性管100的内周面的第一曲面132和连接上述第一曲面132的两端的平坦面134。
即，将以往的分散的镜头110和清洗通道120以相互接触的方式集中配置在硬性管100的一侧内周面来可充分确保操作通道130所占据的空间，因此，可最大限度的提高操作通道130的大小。
尤其，根据本发明的实施方式，操作通道130包括紧贴于硬性管100的内周面的第一曲面132和连接上述第一曲面的平坦面134。此时，曲率半径小的第一曲面132占据硬性管100的内周面的70％以上，则操作通道130的断面积变大而大概占据硬性管100断面积的80％以上。
同时，优选地，使操作通道130的平坦面134与镜头110和清洗通道120中直径最大的外周面(图示的实施方式中是镜头)相接触来放大操作通道130的大小。
根据如上所述的本发明的操作通道130的形态与以往的正圆形态不同，可形成类似隧道的形态。随之，操作通道130的断面积大概放大到以往的2倍以上，因此，通过脊椎内窥镜1来进行椎间盘手术时与以往相比，不仅能够选择手术钳和钻孔器等辅助设备的余地，而且使用辅助设备空间大，从而具有容易手术的优点。
并且，可以使用大小更大的手术钳和钻孔器等辅助设备，其意味着提高了在规定时间内使用辅助设备来处理的手术量，结果，能够缩短手术时间来有助于患者的恢复。
尤其，根据本发明的操作通道130的隧道形态，执行人工椎间盘置换术或脊椎融合术时，可不触碰神经和肌肉并使最大的椎间融合器(CG)也可通过操作通道130来插入(参照图5)。因此，不需要剖开更长的患部，能够只用本发明的硬性脊椎内窥镜来进行及完成重症盘手术，从而减轻患者对手术的负担并期待以微创手术本来的目的的较快恢复速度。
在上述中对本发明的优选实施例及实施方式进行了图示和说明，但只要是本发明所属技术领域的普通技术人，就可以在不脱离本发明要求保护范围中所定义的本发明的思想及范围的情况下，对本发明进行多种变形实施。因此，本发明的发明要求保护范围根据发明要求保护范围所记载内容及其等同技术方案来定。
Claims (2)
1.一种硬性脊椎内窥镜，
包括：
硬性管，向内窥镜的前端突出；
镜头，设置在上述硬性管的内部，与用于观察患部的摄像装置相连接；
清洗通道，喷射用于清洗上述患部的清洗水；
操作通道，使脊椎手术时需要的辅助设备进入上述患部；以及
光纤维，用于照射照明光，
上述硬性脊椎内窥镜的特征在于，
上述镜头和清洗通道之间以相互接触的方式紧贴配置在上述硬性管的一侧内周面，上述操作通道呈隧道形状，包括与上述硬性管的内周面的70％以上紧贴的第一曲面和连接上述第一曲面的两端的平坦面，
上述操作通道的平坦面与上述镜头和清洗通道中直径最大的外周面相接触。
2.根据权利要求1所述的硬性脊椎内窥镜，其特征在于，能够使椎间融合器经上述操作通道通过。
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| KR101982810B1 (ko) | 2017-07-18 | 2019-05-27 | 원텍 주식회사 | 이미지 센서가 내장된 수술용 내시경 |
| KR101999536B1 (ko) | 2017-08-28 | 2019-10-01 | 주식회사 텍코드 | 경피적 내시경 수술용 본스칼펠 |
| KR102276725B1 (ko) | 2017-09-12 | 2021-07-14 | 주식회사 루맥스 | 세척기능이 구비된 카테터 및 그 운용방법 |
| US11331091B2 (en) * | 2017-11-14 | 2022-05-17 | Endovision Co., Ltd. | Surgical instrument set for use during unilateral biportal endoscopy |
| CN108577955B (zh) * | 2018-04-02 | 2024-03-29 | 陈小敏 | 一种腰椎侧前方入路自锁式椎间融合固定装置 |
| CN209236111U (zh) * | 2018-11-01 | 2019-08-13 | 山东冠龙医疗用品有限公司 | 一种多通道微创通道用内窥镜 |
| CN109330554A (zh) * | 2018-11-19 | 2019-02-15 | 周颖 | 一种椎管内视镜系统 |
| CN211325228U (zh) * | 2019-10-16 | 2020-08-25 | 山东冠龙医疗用品有限公司 | 一种多通道工作套管 |
| KR102208305B1 (ko) * | 2020-06-17 | 2021-01-27 | 주식회사 텍코드 | 골유합술용 케이지 수술 시스템 |
| CN112274234B (zh) * | 2020-10-28 | 2021-10-15 | 珠海维尔康生物科技有限公司 | 一种脊柱镜下中空螺钉系统 |
| KR102540237B1 (ko) * | 2020-12-14 | 2023-06-07 | 주식회사 텍코드 | 체강 삽입 유도 기구 |
| KR102417210B1 (ko) * | 2021-12-13 | 2022-07-07 | 주식회사 텍코드 | 골유합술용 내시경 기구 |
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