CN108742732B - Skull base repairing device for minimally invasive surgery of pituitary adenoma through sphenoidal sinus - Google Patents
Skull base repairing device for minimally invasive surgery of pituitary adenoma through sphenoidal sinus Download PDFInfo
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- CN108742732B CN108742732B CN201810613668.1A CN201810613668A CN108742732B CN 108742732 B CN108742732 B CN 108742732B CN 201810613668 A CN201810613668 A CN 201810613668A CN 108742732 B CN108742732 B CN 108742732B
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- pituitary adenoma
- invasive surgery
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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
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
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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
- A61B17/00491—Surgical glue applicators
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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
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
Abstract
The invention discloses a skull base repairing device for minimally invasive surgery of pituitary adenoma through sphenoidal sinus, which comprises an annular guide rail, a bracket arranged in the middle of the annular guide rail, a circumference driving device, a radial adjusting device, an elastic leakage-proof device and a feeding device, wherein the circumference driving device is arranged on the bracket; the radial adjusting device comprises a rotating transverse plate moving along the radius direction of the annular guide rail, a screw rod is connected to the rotating transverse plate, an adjusting plate clamped inside the rotating transverse plate is connected to the screw rod, the adjusting plate drives the elastic leakage-proof device to do linear reciprocating motion along with the rotation of the screw rod, the elastic leakage-proof device comprises a skull supporting plate arranged at the top of the adjusting plate, a liquid injection cavity and an extrusion cavity are arranged on the skull supporting plate, an arc-shaped pressing plate is arranged inside the extrusion cavity, and air bags are arranged on two sides of one side of the arc-shaped pressing. The invention has reasonable design, can quickly adjust the repairing position in multiple directions, reduces the operation difficulty, doubly seals and fits the skull wound, prevents the repairing liquid from leaking outwards, and improves the quality of the transcranial operation.
Description
Technical Field
The invention relates to the technical field of medical equipment, in particular to a skull base repairing device for a sphenoid sinus pituitary adenoma minimally invasive surgery.
Background
For more than 20 years, the popularization of hypophysial tumor resection via sphenoid sinus approach gradually reduces the proportion of transcranial operation, but the two approaches are difficult to replace each other due to the difference of growth and expansion directions of the pituitary tumor, and have respective existing values. Guiot (1973) reported that only 28% of its personal surgical 563 pituitary tumors were absolutely eligible for transsphenoid sinus access, 10.5% were absolutely eligible for transcranial access, and the remaining 61.5% of patients received satisfactory treatment with either of these two approaches. However, the death rate and disability rate of the transcranial operation are higher than those of the transsphenoidal operation, so the transsphenoidal operation is mostly adopted at last. In recent years, with the development of the microneurosurgic technology, although many authors have achieved great performance by excising a huge pituitary tumor extending above the saddle through the sphenoid sinus approach, or by using intraoperative ultrasound monitoring, endoscopic assistance, neuronavigation techniques (Elias, 1999), etc., through an intracranial microscope direct-viewing operation, the relationship between the upper pole of the tumor and the optic nerve, the internal carotid artery and the pituitary stalk can be more clearly revealed, thereby contributing to the protection of the above structure and excising more tumors extending above the saddle.
However, after the pathological changes are removed, the skull base sclerotin, the dura mater and the local soft tissue of the operative field are damaged greatly, and the possibility of postoperative complications such as cerebrospinal fluid leakage, meningitis, pneumocranium and cerebral bulging is increased. In order to reduce complications, the skull base defect must be repaired after the operation, at present, because the operation incision is expanded through the sphenoid sinus to treat the inside of the skull base, when the operation position is complicated, if the operation is carried out through the sphenoid sinus entrance, the entrance of the operation needs to be expanded to carry out the operation on the inside, when the operation position is far away from the entrance of the sphenoid sinus, the operation difficulty is increased, the expanded sphenoid sinus entrance is repaired to be complicated, when operations such as aneurysm occur, if the operation is carried out through the slope skull base, the operation path is shortened, the operation area is exposed to be clearer, but because the slope part can not be compounded for repairing the skull base after the operation is completed, intracranial and intracranial communicating cavities can occur, cerebrospinal fluid leakage phenomenon can not be repaired, and the skull base has great limitation in the actual operation. Therefore, we propose a skull base repair device for minimally invasive surgery via sphenoid sinus pituitary adenoma to solve the above problems.
Disclosure of Invention
Based on the technical problems of high operation difficulty, easy leakage of cerebrospinal fluid and incapability of repairing the basis cranii in the background technology, the invention provides a basis cranii repairing device for a minimally invasive operation of sphenoidal-sinus pituitary adenoma.
The invention provides a skull base repairing device for a sphenoid sinus pituitary adenoma minimally invasive surgery, which comprises an annular guide rail, a bracket arranged in the middle of the annular guide rail, a circumference driving device, a radial adjusting device, an elastic leakage-proof device and a feeding device, wherein the circumference driving device is arranged on the bracket;
the radial adjusting device comprises a rotating transverse plate which moves along the radius direction of the annular guide rail, a screw rod is rotatably connected inside the rotating transverse plate, an adjusting plate clamped inside the rotating transverse plate is connected onto the screw rod, the adjusting plate drives the elastic leakage-proof device to linearly reciprocate along with the rotation of the screw rod, and the elastic leakage-proof device comprises a skull supporting plate arranged at the top of the adjusting plate;
the skull supporting plate is provided with a liquid injection cavity and an extrusion cavity, an arc-shaped pressing plate is arranged inside the extrusion cavity, air bags are arranged on two sides of one side of the arc-shaped pressing plate and used for pushing the liquid injection cavity to be tightly attached to a skull, the feeding device is arranged on one side of the skull supporting plate, and a repairing material is injected into the liquid injection cavity in a pneumatic mode;
the middle part of one side of arc clamp plate is provided with the fixed block, and the both sides of fixed block are all rotated and are connected with movable bull stick, be provided with two relative locating pieces on the one side inner wall that the liquid chamber was kept away from to the extrusion chamber, be connected with the litter between two locating pieces, be provided with two elasticity ejector pads on the litter, and two elasticity ejector pads correspond and rotate with the one end of two movable bull sticks and be connected.
Preferably, the skull supporting plate is of an arc-shaped structure, the shapes of the sliding rod and the arc-shaped pressing plate are respectively fit with the shapes of the skull supporting plate, the length of the sliding rod is greater than the total length of the two movable rotating rods, and the elastic push block is connected with the sliding rod in a sliding mode.
Preferably, the slide rod is sleeved with a spring, and the spring is positioned on one side of the two elastic push blocks away from each other.
Preferably, the bracket is composed of a support portion and a connecting portion provided between the support portion and the endless guide.
Preferably, the circumference drive arrangement sets up in the top of supporting part, the circumference drive arrangement includes the fixed bolster, and the top of fixed bolster is equipped with first motor, is connected with the pivot on the bottom output shaft of first motor, and the one end of pivot with rotate diaphragm fixed connection and drive and rotate the diaphragm rotation.
Preferably, the inside of rotation diaphragm still is equipped with the second motor, and the output shaft and the screw rod of second motor are connected.
Preferably, the bottom of one side of the rotating transverse plate far away from the fixed support is provided with a movable block, and the movable block slides in the inner circumference of the annular guide rail.
Preferably, feeding device includes the stock solution box, one side of stock solution box is connected with the hose, and the one end of hose extends to annotates the liquid intracavity, the top of stock solution box is equipped with annotates the liquid mouth, and the inside of stock solution box is equipped with the piston, and one side of piston is connected with the push rod, and the one end of push rod extends to the outside of stock solution box.
Compared with the prior art, the invention has the beneficial effects that:
1. the circumferential driving device drives the radial adjusting device to rotate circumferentially, so that the position of the elastic leakage-proof device can be adjusted in a large range, meanwhile, the radial position of the elastic leakage-proof device can be adjusted in a small range by utilizing the rotating power of the screw rod and the limiting of the adjusting plate, the rapid repair of different positions of the skull is facilitated, the operation difficulty is reduced, and the operation is simple and convenient;
2. through the elastic structure that sets up gasbag and extrusion arc clamp plate in elasticity leak protection device, dual shutoff is laminated skull wound department, and the shutoff effect is showing, effectively prevents to repair liquid and leaks outward, improves the quality of transcranial operation.
The invention has reasonable design and layout and simple operation, can quickly adjust the repairing position in multiple directions, reduces the operation difficulty, doubly seals and fits the skull wound, prevents the repairing liquid from leaking outside, improves the quality of the transcranial operation, and is suitable for popularization.
Drawings
FIG. 1 is a schematic top view of a cranio-basilar repair device for minimally invasive surgery via sphenoid-sinus pituitary adenoma according to the present invention;
FIG. 2 is a schematic side view of the elastic leakage-proof device for the skull base repairing device for the minimally invasive operation of sphenoid sinus pituitary adenoma according to the present invention;
FIG. 3 is a schematic diagram of the side view of the elastic leakage-proof device for the skull base repairing device for the minimally invasive operation of sphenoidal pituitary adenoma according to the present invention;
FIG. 4 is a schematic top view of the elastic leakage-proof device for the skull base repairing device for the minimally invasive operation of sphenoid sinus pituitary adenoma according to the present invention.
In the figure: the skull bone fracture fixation device comprises a 1 annular guide rail, a 2 fixed bracket, a 3 skull bone supporting plate, a 4 liquid storage box, a 11 supporting part, a 12 connecting part, a 13 movable block, a 21 first motor, a 22 rotating shaft, a 23 rotating transverse plate, a 24 screw rod, a 25 adjusting plate, a 31 liquid injection cavity, a 32 extrusion cavity, a 33 arc-shaped pressing plate, a 34 fixed block, a 35 air bag, a 36 movable rotating rod, a 37 positioning block, a 38 sliding rod, a 39 elastic pushing block, a 40 spring, a 41 hose, a 42 liquid injection port, a 43 piston and a 44 pushing rod.
Detailed Description
The present invention will be further illustrated with reference to the following specific examples.
Example one
Referring to fig. 1-4, a skull base repairing device for a sphenoid sinus pituitary adenoma minimally invasive surgery comprises an annular guide rail 1, a bracket arranged in the middle of the annular guide rail 1, a circumference driving device, a radial adjusting device, an elastic leakage-proof device and a feeding device;
the radial adjusting device comprises a rotating transverse plate 23 which moves along the radius direction of the annular guide rail 1, a screw rod 24 is rotatably connected inside the rotating transverse plate 23, an adjusting plate 25 clamped inside the rotating transverse plate 23 is connected onto the screw rod 24, the adjusting plate 25 rotates along with the screw rod 24 to drive the elastic leakage-proof device to do linear reciprocating motion, and the elastic leakage-proof device comprises a skull supporting plate 3 arranged at the top of the adjusting plate 25;
be equipped with on skull backup pad 3 and annotate liquid chamber 31 and extrusion chamber 32, the inside in extrusion chamber 32 is provided with arc clamp plate 33, and one side both sides of arc clamp plate 33 are provided with gasbag 35, and gasbag 35 promotes annotates liquid chamber 31 and hugs closely the skull, and feeding device locates skull backup pad 3 one side, will repair the material through the pneumatic form and pour into liquid chamber 31 into.
In this embodiment, a fixed block 34 is disposed in the middle of one side of the arc-shaped pressing plate 33, movable rotating rods 36 are rotatably connected to both sides of the fixed block 34, two opposite positioning blocks 37 are disposed on the inner wall of one side of the extrusion cavity 32 away from the injection cavity 31, a sliding rod 38 is connected between the two positioning blocks 37, two elastic pushing blocks 39 are disposed on the sliding rod 38, the two elastic pushing blocks 39 are rotatably connected to one ends of the two movable rotating rods 36, the skull support plate 3 is of an arc-shaped structure, the shapes of the sliding rod 38 and the arc-shaped pressing plate 33 are respectively fitted to the shape of the skull support plate 3, the length of the sliding rod 38 is greater than the total length of the two movable rotating rods 36, the elastic pushing blocks 39 are slidably connected to the sliding rod 38, a spring 40 is sleeved on the sliding rod 38, and the spring 40 is located. Through the elastic structure that the air bag 35 and the extrusion arc-shaped pressing plate 33 are arranged in the elastic leakage-proof device, the two elastic pushing blocks 39 can freely slide on the sliding rod 38 under the elastic effect of the spring 40, synchronously push the two movable rotating rods 36 to rotate diagonally, and assist the side assistance of the air bag 35 to extrude the arc-shaped pressing plate 33 towards the direction of injecting the repair liquid, so that the skull wound is sealed and attached, the sealing effect is remarkable, the repair liquid is prevented from leaking outwards in the operation process, the repair liquid is convenient to inject in the doctor treatment process, the reverse elastic acting force of the spring 40 can be utilized to reversely push the arc-shaped pressing plate 33, only the gap is reserved, the normal injection of the repair liquid is not influenced, the repair liquid can be artificial dura mater, and the quality of transcranial operation is improved.
Feeding device includes stock solution box 4, and one side of stock solution box 4 is connected with hose 41, and in hose 41's one end extended to annotating liquid chamber 31, the top of stock solution box 4 was equipped with annotates liquid mouth 42, and the inside of stock solution box 4 is equipped with piston 43, and one side of piston 43 is connected with push rod 44, and the one end of push rod 44 extended to the outside of stock solution box 4. Now, the repair liquid is led into the liquid storage box 4 from the liquid injection port 42, the push rod 44 is pushed to extrude the piston 43 according to the requirement of the injury of the skull of the patient, the repair liquid is extruded into the liquid injection cavity 31 from the hose 41 under the action of pressure, one or more liquid discharge ports communicated with the inner cavity of the liquid injection cavity 31 can be formed in the outer end surface of the skull supporting plate 3, and the repair liquid can flow out normally and repair the skull of the patient conveniently.
The support comprises supporting part 11 and connecting portion 12, connecting portion 12 sets up between supporting part 11 and ring rail 1, circumference drive arrangement sets up in the top of supporting part 11, circumference drive arrangement includes fixed bolster 2, the top of fixed bolster 2 is equipped with first motor 21, be connected with pivot 22 on the bottom output shaft of first motor 21, and the one end of pivot 22 with rotate diaphragm 23 fixed connection and drive and rotate diaphragm 23 rotation, the inside of rotating diaphragm 23 still is equipped with the second motor, and the output shaft of second motor is connected with screw rod 24, it is provided with movable block 13 to rotate diaphragm 23 one side bottom of keeping away from fixed bolster 2, and movable block 13 is circumference slip in ring rail 1. The first motor 21 through the circumference drive arrangement drives the pivot 22 and rotates, make radial adjusting device's rotation diaphragm 23 circumference thereupon rotate, it also can freely slide in ring rail 1 to rotate in-process movable block 13, can adjust elasticity leak protection device's position on a large scale, it is rotatory to utilize second motor drive screw rod 24 simultaneously, the second motor can adopt two-way motor, make under the spacing of regulating plate 25 self and under the rotary power of screw thread, can be along the length direction reciprocating motion of screw rod 24, the radial position of regulation elasticity leak protection device that can the minizone, conveniently repair fast the different positions of skull, reduce the operation degree of difficulty, and easy and simple to handle.
Example two
An adjusting handle is further arranged outside one side of the rotating transverse plate 23 and fixedly connected with one end of the screw rod 24, the adjusting handle can be rotated manually to drive the screw rod 24 to rotate, and then the adjusting plate 25 is driven to move under the rotating power of the threads, so that the purpose of adjusting different positions of the skull supporting plate 3 is achieved, the cost is saved, the skull can be repaired quickly at different positions conveniently, and the operation difficulty is reduced.
The above description is only for the preferred embodiment of the present invention, but the scope of the present invention is not limited thereto, and any person skilled in the art should be considered to be within the technical scope of the present invention, and the technical solutions and the inventive concepts thereof according to the present invention should be equivalent or changed within the scope of the present invention.
Claims (8)
1. A skull base repairing device for minimally invasive surgery of sphenoid sinus pituitary adenoma comprises an annular guide rail (1) and a bracket arranged in the middle of the annular guide rail (1), and is characterized by further comprising a circumference driving device, a radial adjusting device, an elastic leakage-proof device and a feeding device;
the radial adjusting device comprises a rotating transverse plate (23) which moves along the radius direction of the annular guide rail (1), a screw rod (24) is rotatably connected inside the rotating transverse plate (23), an adjusting plate (25) clamped inside the rotating transverse plate (23) is connected onto the screw rod (24), the adjusting plate (25) rotates along with the screw rod (24) to drive the elastic leakage-proof device to do linear reciprocating motion, and the elastic leakage-proof device comprises a skull supporting plate (3) arranged at the top of the adjusting plate (25);
the skull supporting plate (3) is provided with a liquid injection cavity (31) and a squeezing cavity (32), an arc-shaped pressing plate (33) is arranged inside the squeezing cavity (32), air bags (35) are arranged on two sides of one side of the arc-shaped pressing plate (33), the air bags (35) push the liquid injection cavity (31) to be tightly attached to the skull, the feeding device is arranged on one side of the skull supporting plate (3), and a repairing material is injected into the liquid injection cavity (31) in a pneumatic mode;
the improved injection mold is characterized in that a fixing block (34) is arranged in the middle of one side of the arc-shaped pressing plate (33), movable rotating rods (36) are connected to the two sides of the fixing block (34) in a rotating mode, two opposite positioning blocks (37) are arranged on the inner wall, away from the injection cavity (31), of the extrusion cavity (32), a sliding rod (38) is connected between the two positioning blocks (37), two elastic pushing blocks (39) are arranged on the sliding rod (38), and the two elastic pushing blocks (39) are correspondingly connected with one ends of the two movable rotating rods (36) in a rotating mode.
2. The skull base repair device for minimally invasive surgery of pituitary adenoma via a sphenoidal sinus according to claim 1, characterized in that the skull support plate (3) is of an arc-shaped structure, the shapes of the slide rod (38) and the arc-shaped pressure plate (33) are respectively fitted with the shape of the skull support plate (3), the length of the slide rod (38) is greater than the total length of the two movable rotating rods (36), and the elastic push block (39) is connected with the slide rod (38) in a sliding manner.
3. The skull base repair device for minimally invasive surgery on sphenoid sinus pituitary adenoma according to claim 2, characterized in that the slide rod (38) is sleeved with a spring (40), and the spring (40) is positioned at the side where the two elastic push blocks (39) are far away.
4. Cranio-basilar repair device for minimally invasive surgery of a sphenoid-pituitary adenoma according to claim 1, characterized in that the support consists of a support (11) and a connecting portion (12), the connecting portion (12) being arranged between the support (11) and the annular rail (1).
5. The basis cranii patching device for minimally invasive surgery on pituitary adenoma via sphenoids according to claim 4, wherein the circumference driving device is arranged at the top of the supporting part (11), the circumference driving device comprises a fixed bracket (2), a first motor (21) is arranged at the top of the fixed bracket (2), a rotating shaft (22) is connected to an output shaft at the bottom of the first motor (21), and one end of the rotating shaft (22) is fixedly connected with a rotating transverse plate (23) to drive the rotating transverse plate (23) to rotate.
6. The skull base repair device for minimally invasive surgery on pituitary adenoma via sphenoidal sinus according to claim 5, characterized in that a second motor is further arranged inside the rotating transverse plate (23), and an output shaft of the second motor is connected with the screw rod (24).
7. The skull base repair device for minimally invasive surgery on pituitary adenoma via a sphenoidal sinus according to claim 5, characterized in that the bottom of the side of the rotating transverse plate (23) far away from the fixed bracket (2) is provided with the movable block (13), and the movable block (13) slides on the inner circumference of the annular guide rail (1).
8. The basis cranii patching device for minimal access surgery through sphenoidal sinus pituitary adenoma according to claim 1, characterized in that the feeding device comprises a liquid storage box (4), one side of the liquid storage box (4) is connected with a hose (41), one end of the hose (41) extends into the liquid injection cavity (31), the top of the liquid storage box (4) is provided with a liquid injection port (42), the inside of the liquid storage box (4) is provided with a piston (43), one side of the piston (43) is connected with a push rod (44), and one end of the push rod (44) extends to the outside of the liquid storage box (4).
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201810613668.1A CN108742732B (en) | 2018-06-14 | 2018-06-14 | Skull base repairing device for minimally invasive surgery of pituitary adenoma through sphenoidal sinus |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201810613668.1A CN108742732B (en) | 2018-06-14 | 2018-06-14 | Skull base repairing device for minimally invasive surgery of pituitary adenoma through sphenoidal sinus |
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| CN108742732A CN108742732A (en) | 2018-11-06 |
| CN108742732B true CN108742732B (en) | 2020-02-18 |
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| CN201810613668.1A Active CN108742732B (en) | 2018-06-14 | 2018-06-14 | Skull base repairing device for minimally invasive surgery of pituitary adenoma through sphenoidal sinus |
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| CN110292400B (en) * | 2019-07-05 | 2020-09-18 | 浙江大学 | Intranasal pituitary adenoma positioning device based on ultrasonic blood flow detection and guidance |
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| US9220595B2 (en) * | 2004-06-23 | 2015-12-29 | Orthovita, Inc. | Shapeable bone graft substitute and instruments for delivery thereof |
| US20120265312A1 (en) * | 2011-04-01 | 2012-10-18 | Shawn Burke | System and Method for Manufacture of a Cranial Repair Implant and a Cranial Repair Implant Produced Thereby |
| CN103505254A (en) * | 2013-10-05 | 2014-01-15 | 王学建 | Skull base coloboma reestablishment device |
| CN204971383U (en) * | 2015-09-14 | 2016-01-20 | 西安东澳生物科技有限公司 | Device is repaired to basis cranii of evacuation structure |
| CN105496470B (en) * | 2016-01-24 | 2018-03-30 | 哈尔滨理工大学 | A kind of mammary gland pushing device in nuclear-magnetism environment menisectomy |
| CN106668935B (en) * | 2016-11-22 | 2020-03-06 | 大博医疗科技股份有限公司 | Expanded polytetrafluoroethylene artificial dura mater and preparation process thereof |
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