CN110882019A - Retracting and cleaning device for brain surgery and using method thereof - Google Patents
Retracting and cleaning device for brain surgery and using method thereof Download PDFInfo
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- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
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Abstract
The invention relates to a retracting and cleaning device for brain surgery and a using method thereof, comprising a liquid suction rod, wherein the outer wall of the liquid suction rod is provided with a first supporting plate for supporting a thumb; the support mechanism is arranged on the side wall of the liquid suction rod, which is far away from the first supporting plate, and is used for supporting the index finger of a user; the bottom of the supporting mechanism is provided with a third supporting plate, and the third supporting plate is used for supporting the middle finger; the invention utilizes the liquid suction rod to pull open the brain tissue, can quickly and conveniently retract the operation gap, and realizes the non-traction operation; the brain tissue necrosis can be effectively avoided, and the lossless traction is realized; the supporting mechanism can make the doctor more comfortable during the operation and can not feel hurting the hand.
Description
Technical Field
The invention relates to a retracting and cleaning device for brain surgery and a using method thereof, and belongs to the technical field of medical instruments.
Background
Because the positions of the tumors at the basis of cranium and deep brain are deeper, the blocking of the shallow pathological tissue hinders the exposure of the deep pathological tissue during the operation, and peripheral nerve vessels or brain tissue need to be pulled during the operation to achieve the purposes of increasing the exposure and being convenient for cutting off the tumors; in the traction operation, conventional instruments such as a liquid suction rod, a scalpel, an electric coagulation forceps, a traction device and the like are required;
the existing cleaning device is a liquid suction rod which is used in the whole operation process and is used for cleaning effusion, blood and tissues of the brain; however, the surface of the existing liquid suction rod lacks a supporting and protecting structure, each finger of a doctor directly contacts with the outer wall of the cylindrical liquid suction rod, the liquid suction rod needs to be held for a long time in an operation, the fingers of the doctor are collided by the rod part and are very painful, and the flexibility and the accuracy of the fingers of the doctor during operation are influenced;
the current traction device is a retractor and a brain pressing plate, and the retraction process is as follows: retracting an operation gap on the skull, mounting a retractor on one side of the skull, then mounting a brain pressing plate on the retractor, penetrating the brain pressing plate through the operation gap and poking open brain tissues, and performing operation on deep brain tissues by a doctor by using a liquid suction rod and electric coagulation forceps; the existing traction device has the following defects: the retractor and the brain pressing plate are continuously used, and the brain pressing plate can press brain tissues for a long time, so that complications such as cerebral contusion, cerebral edema, intracerebral hematoma and the like can be caused;
therefore, the existing cleaning device and the existing traction device have defects, so that the effect of the traction operation is not ideal, and the equipment used in the whole traction operation is too much, so that the operation is complicated, the time consumption is long, and the cost is high.
The patent publication No. CN105769268A discloses a flexible retracting assembly, which comprises an expanding sacculus, a supporting tube, connecting seats, a locking mechanism and a pressurizing device connector, wherein the expanding sacculus is made of elastic materials and can be retracted to enter a diseased part and form a retracting channel for the diseased part; the brain pressing plate is sleeved at the far end of the flexible retracting component and enters the retracting channel to enable the retracting channel to be in a retracting state, and the patent adopts an air bag to expand brain tissue, so that the effect of enlarging an operation gap is achieved, and a retractor is not needed; however, the air bag occupies a large space, so that the operation sight of a doctor is easily blocked, the surgical instrument is not convenient to stretch into the air bag, and the opening and closing gap is not easy to control.
Disclosure of Invention
Aiming at the defects in the prior art, the invention provides a retracting and cleaning device for brain surgery and a use method thereof, and the specific technical scheme is as follows:
a retracting and cleaning device for brain surgery comprises a liquid suction rod, wherein a first supporting plate used for supporting a thumb is arranged on the outer wall of the liquid suction rod; the support mechanism is arranged on the side wall of the liquid suction rod, which is far away from the first supporting plate, and is used for supporting the index finger of a user; and a third supporting plate is arranged at the bottom of the supporting mechanism and used for supporting the middle finger.
Preferably, the supporting mechanism comprises a supporting component and a second supporting plate, one end of the supporting component is fixedly connected with the liquid sucking rod, the other end of the supporting component is rotatably connected with the second supporting plate, the second supporting plate is used for supporting the index finger, and the second supporting plate is positioned at the top of the first supporting plate; the cross section of the second supporting plate is arc-shaped, and the second supporting plate protrudes towards one side of the liquid suction rod.
Preferably, the supporting part includes a supporting seat and a connecting column, the supporting seat with imbibition pole vertical fixation, open the inside of supporting seat has the spacing groove, the one end of connecting column is equipped with spherical connector, the connector rotate imbed in the spacing groove, the other end of connecting column is connected the second layer board.
Preferably, the support mechanism further comprises a flexible contact member, and the flexible contact member is arranged on the second supporting plate and the inner wall of the limiting groove.
Preferably, the imbibition pole is including the first body, hyaline tube and the second body that connect gradually, the both ends of hyaline tube be the first body of be assembled between/be connected with and the second body respectively.
A use method of the retracting and cleaning device for brain surgery comprises the following steps:
s1, making a brain incision;
s2, performing distraction cleaning on the brain incision;
s2.1, forming a preliminary gap between the brain tissue and the skull in the brain incision by using an auxiliary means;
s2.2, retracting the brain tissue:
s2.2.1, assembling and holding the liquid absorbing rod: assembling the first pipe body, the observation pipe and the second pipe body after cleaning and sterilization to form a liquid absorption rod; holding the liquid sucking rod in a pen holding state, so that a thumb is placed on the first supporting plate, a forefinger is placed on the supporting mechanism, and a middle finger is placed on the third supporting plate;
s2.2.2, extending the liquid absorbing rod into the preliminary gap;
s2.2.3, applying a force to the suction wand on a side facing away from the skull, such that a gap between the brain tissue and the skull increases, the preliminary gap transitioning to an operative gap; and the liquid suction rod is utilized to clean blood, effusion and tissues at the operation gap.
Preferably, S2.1 is specifically: regulating the hydrocephalus and the cerebral blood to ensure that the hydrocephalus and the cerebral blood are in the lower limit of normal values; the position of the patient is adjusted so that the head is inclined downwards and the horizontal distance between the head and the heart is more than 10 cm.
Preferably, the regulation method of the cerebral blood comprises the steps of carbon dioxide partial pressure, anesthesia depth regulation and 20% mannitol injection; the regulating method of hydrocephalus comprises lumbar effusion drainage.
Preferably, the S1 includes:
s1.1, preparation of surgical operation:
s1.2, judging the position of the lesion tissue:
s1.2.1, the position of the lesion tissue is positioned outside the brain tissue:
sequentially cutting the scalp, the skull and the meninges, and entering S2.2;
s1.2.2, the location of the lesion tissue is within the brain tissue:
sequentially incising scalp, skull and meninges;
the superficial brain tissue is incised to form a brain space, and the brain space enters S2.1.
Preferably, the process from S1 to S2 requires the following steps to be carried out without interruption:
covering brain cotton and gelatin sponge on the exposed brain tissue;
and observing the flowing condition of the liquid in the liquid suction rod through the transparent tube, and adjusting the liquid suction rod according to the flowing condition.
The invention has the beneficial effects that:
1. the supporting plate can make a doctor feel more comfortable during operation, and the thumb, the index finger and the middle finger do not feel hurting hands; the supporting component is arranged to enable the supporting plate to rotate freely, and the supporting component is suitable for different holding postures.
2. Brain tissues are poked by the liquid suction rod body, so that operation gaps can be quickly and conveniently retracted, non-traction operation is realized, no surgical instrument is required to be added, the operation sight of a doctor cannot be blocked, and the operation space is large; doctor can be continuous removes the imbibition pole in the operation, and the imbibition pole is when changing the position, and the oppression dynamics that the brain received and oppression position also can change thereupon, and the in-process of change, brain tissue have also obtained transient release, and blood, hydrops can normally flow to avoid long-time oppression to lead to the condition of brain tissue necrosis to take place, realize harmless tractive.
3. Adopt multiple auxiliary means to increase the operation clearance, reduce brain liquid volume for the operation is more simple and convenient, and the traction effect of imbibition pole is better.
The device provided by the invention can complete brain traction and liquid suction only by using the liquid suction rod without using other instruments, thereby greatly improving the operation efficiency and reducing the cost.
Drawings
Fig. 1 is a schematic structural view of a retracting and cleaning device for brain surgery according to the invention;
FIG. 2 is a schematic side cross-sectional view of a wicking apparatus according to the present invention;
FIG. 3 is a schematic perspective view of the support mechanism of the present invention;
FIG. 4 is a schematic view of a connection structure of a support base and a connecting column according to the present invention;
FIG. 5 is a schematic view of a pipette tip configuration shown in the present invention;
FIG. 6 is a schematic view of a holding configuration of the wicking apparatus of the present invention;
reference numerals: 1. liquid suction rod, 11, first body, 12, observation tube, 13, second body, 2, first layer board, 3, supporting mechanism, 31, supporting seat, 311, spacing groove, 32, spliced pole, 321, connector, 33, second layer board, 34, flexible contact spare, 4, third layer board.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention more apparent, the present invention is described in further detail below with reference to the accompanying drawings and embodiments. It should be understood that the specific embodiments described herein are merely illustrative of the invention and are not intended to limit the invention.
A retracting and cleaning device for brain surgery comprises a liquid suction rod 1, wherein a first supporting plate 2 used for supporting a thumb is arranged on the outer wall of the liquid suction rod 1; the support mechanism 3 is arranged on the side wall of the liquid absorbing rod 1, which is far away from the first supporting plate 2, and the support mechanism 3 is used for supporting the index finger of a user; the bottom of the supporting mechanism 3 is provided with a third supporting plate 4, and the third supporting plate 4 is used for supporting the middle finger; the first supporting plate 2, the supporting mechanism 3 and the third supporting plate 4 can support the thumb, the index finger and the middle finger, so that the operation is more convenient, and the hand can not be hurled; the problem of calculating ache by holding the fingers for a long time is solved, and the sensitivity and the accuracy of a doctor when operating the liquid suction rod 1 are ensured.
As an improvement of the above technical solution, the supporting mechanism 3 includes a supporting member and a second supporting plate 33, one end of the supporting member is fixedly connected to the liquid sucking rod 1, the other end of the supporting member is rotatably connected to the second supporting plate 33, the second supporting plate 33 is used for supporting the index finger, and the second supporting plate 33 is located on the top of the first supporting plate 2; the second supporting plate 33 is used for supporting and protecting the index finger, so that the index finger is prevented from being extruded by the liquid suction rod 1, and the holding comfort is improved; the supporting part is rotatably connected with the second supporting plate 33, so that the second supporting plate 33 can move along with the movement of fingers, the supporting flexibility is increased, and the operation of a doctor is more convenient.
The section of the second supporting plate 33 is arc-shaped, and the second supporting plate 33 protrudes towards one side of the liquid suction rod 1; the arc-shaped structure can enable the second supporting plate 33 to be more matched with the shape of fingers, so that the second supporting plate is more comfortable to fit; and the concave cambered surface can wrap fingers, so that a certain positioning effect is achieved.
As an improvement of the above technical solution, the supporting member includes a supporting seat 31 and a connecting column 32, the supporting seat 31 is vertically fixed to the liquid absorbing rod 1, a limiting groove 311 is formed in the supporting seat 31, a spherical connector 321 is arranged at one end of the connecting column 32, the connector 321 is rotatably embedded in the limiting groove 311, and the other end of the connecting column 321 is connected to the second supporting plate 33; spherical connector 321 can restrict in spacing groove 311 and rotate, can realize second layer board 33 free rotation for bearing structure is more nimble, changeable, and application scope is wider.
As an improvement of the above technical solution, the supporting mechanism 3 further includes a flexible contact member 34, and the flexible contact member 34 is disposed on the inner walls of the second supporting plate 33 and the limiting groove 311; the flexible contact piece 34 is used for increasing the firmness of connection, the supporting plate can be stably arranged at a rotating position, and the flexible contact piece 34 also enables the joint of the forefinger and the second supporting plate 33 to be more comfortable and does not damage hands; the exemplary flexible contact 34 is a rubber pad, but is not so limited.
As an improvement of the above technical solution, the liquid suction rod 1 includes a first tube 11, a transparent tube 12 and a second tube 13 which are connected in sequence, and the first tube 11 and the second tube 13 are respectively assembled and connected to two ends of the transparent tube 12; the first tube body 11, the second tube body 13 and the transparent tube 12 are connected in an assembling way, so that a doctor can disassemble the liquid absorbing rod 1, residual tissues and liquid in the liquid absorbing rod 1 can be cleaned, the cleanliness of the liquid absorbing rod 1 is ensured, cross infection is avoided, and the transparent tube 12 is used for conveniently observing whether blockage exists; illustratively, the transparent tube 12 is screwed to the first tube 11 and the third tube 13 at two ends.
As shown in fig. 1, fig. 1 is a schematic structural view of a retracting and cleaning device for brain surgery according to the present invention;
the top end of the liquid suction rod 1 is provided with a negative pressure joint which is communicated to an aspirator main body through a hose, and the aspirator main body is exemplarily of a Swan peak LX-3 type;
the outer surface of the liquid absorbing rod 1 is provided with a disc-shaped first supporting plate 2, and the first supporting plate 2 is used for supporting a thumb;
the back of the liquid suction rod 1 is provided with an arc-shaped supporting mechanism 3, and the supporting mechanism 3 and the first supporting plate 2 are oppositely positioned on two side surfaces; the bottom of the supporting mechanism 3 is provided with a third supporting plate 4 in a disc shape; the third supporting plate 4 is in a shape of a circular sheet;
the joint close to the palm is taken as an initial point, and the first joint, the second joint and the third joint are arranged outwards in sequence, so that the second supporting plate 33 is used for supporting the first joint of the index finger, and the third joint of the index finger can be lapped on the outer wall of the liquid suction rod 1; the third supporting plate 4 is used for supporting the third joint of the middle finger.
FIG. 2 is a schematic side cross-sectional view of the wicking apparatus of the present invention, as shown in FIGS. 2 and 3; FIG. 3 is a schematic perspective view of the support mechanism of the present invention;
the supporting mechanism 3 comprises a supporting seat 31, a connecting column 32 and a second supporting plate 33, the supporting seat 31 is vertically welded with the liquid suction rod 1, the supporting seat 31 is connected with the second supporting plate 33 through the connecting column 32, and the section of the second supporting plate 33 is in a semicircular arc shape and protrudes towards the liquid suction rod 1;
the inner wall of the second supporting plate 33 is glued with a flexible contact piece 34, and the flexible contact piece 34 can make the joint of the index finger and the second supporting plate 33 more comfortable and not hurting hands.
As shown in fig. 4, fig. 4 is a schematic view of a connection structure of a support base and a connecting column according to the present invention;
a three-quarter ball groove structure limiting groove 311 is formed in the connecting seat 31, the connecting head 321 is in a ball shape, and three quarters of the connecting head 321 is embedded into the limiting groove 311; the supporting seat 31 can be rotationally connected with the connecting column 32 through the ball groove structure, so that the second supporting plate 33 can move along with the index finger of a doctor to rotate when the doctor operates, and the second supporting plate 33 can be guaranteed to support and protect the index finger all the time;
the inner wall of the limiting groove 311 is glued with the flexible contact piece 34, so that the matching tightness of the connector 321 and the limiting groove 311 can be improved, and the connector 321 can be kept at a certain position when no large force is applied to the outside after being rotated to a certain angle.
FIG. 5 is a schematic view of a pipette tip configuration of the present invention, as shown in FIG. 5;
the liquid absorption rod 1 comprises a first pipe body 11, an observation pipe 12 and a second pipe body 13, wherein the upper end of the observation pipe 12 is in threaded connection with the first pipe body 11, and the lower end of the observation pipe 12 is in threaded connection with the second pipe body 13; the first support plate 2, the second support plate 33 and the third support plate 4 are all installed on the first pipe body 11.
FIG. 6 is a schematic view of the holding configuration of the wicking apparatus of the present invention;
when the doctor is using, wholly be and hold a state, on the second layer board 33 is arranged in to the first joint of forefinger, the third layer board 4 of laminating of the third joint of middle finger, the first layer board 2 is pressed to the thumb to the realization is to the protection of each contact point, has solved the painful problem that the doctor operated the finger and was pressed after holding imbibition pole 1 for a long time.
A use method of the retracting and cleaning device for brain surgery comprises the following steps:
s1, making a brain incision;
s2, performing distraction cleaning on the brain incision;
s2.1, forming a preliminary gap between the brain tissue and the skull in the brain incision by using an auxiliary means; the subsequent retracting operation can be more convenient through the preliminary gap, and the retracting width can meet the surgical requirements on the premise of not needing too great force;
s2.2, retracting the brain tissue:
s2.2.1, assembling and holding the liquid absorbing rod 1: assembling the first tube body 11, the observation tube 12 and the second tube body 13 after cleaning and sterilization to form the liquid absorbing rod 1; holding the liquid sucking rod 1 in a pen holding state, so that a thumb is placed on the first supporting plate 2, a forefinger is placed on the supporting mechanism 3, and a middle finger is placed on the third supporting plate 4; the liquid suction rod 1 adopts an assembly structure, so that the cleaning is convenient; each supporting plate can protect each contact point, and the problem that a doctor feels pain when holding the liquid suction rod 1 for a long time is solved; the operation precision and flexibility are improved;
s2.2.2, the liquid absorbing rod 1 is extended into the preliminary gap;
s2.2.3, applying a force to the liquid suction rod 1 on the side away from the skull, so that the gap between the brain tissue and the skull is increased, and the preliminary gap is converted into an operation gap; the liquid suction rod 1 is used for cleaning blood, effusion and tissues at the operation gap; the liquid suction rod 1 has three purposes in the step, and the first purpose is that the liquid suction rod can be used as a support rod to abut against the brain tissue and apply force to the brain tissue, so that the brain tissue moves back to the side of the skull, and floating retraction of the brain tissue is realized; the doctor can change the compression force of the liquid suction rod 1 according to the size of the required operation gap, so that the operation gap can be expanded to a proper size, and the operation is convenient; when the liquid suction rod 1 is used for poking the brain, the liquid suction rod 1 can press the circulation pipelines of the blood and the tissue fluid of the brain tissue, so that the outflow volume of the liquid is reduced, the operation is convenient, but the pressing time cannot be too long, the activity of the brain tissue can be influenced, a doctor can continuously move the liquid suction rod 1 in the operation, the pressing force and the pressing position on the brain can be changed while the position of the liquid suction rod 1 is changed, the brain tissue is released temporarily in the changing process, and the blood effusion and the tissue fluid can flow normally, so that the situation that the brain tissue is necrotic is effectively avoided; secondly, the liquid suction rod 1 can be continuously moved in a reciprocating manner, so that the end part of the liquid suction rod 1 can cut open brain tissues, and a cutting effect is achieved; thirdly, the liquid suction rod 1 can absorb blood, effusion and tissues, so that too much liquid can not be gathered in the gap of the brain, and the normal operation of the operation is ensured;
as an improvement of the above technical solution, the S2.1 specifically is: regulating the hydrocephalus and the cerebral blood to ensure that the hydrocephalus and the cerebral blood are in the lower limit of normal values; adjusting the body position of the patient to enable the head to incline downwards, wherein the horizontal distance between the head and the heart is more than 10 cm; the lower limit of the normal values of hydrocephalus and cerebral blood can reduce the liquid in the brain, thus being convenient for operation; the body position of the patient is adjusted, the body of the patient is horizontal, the head inclines downwards to form 30 degrees, the horizontal distance between the head and the heart is larger than 10cm, the center of gravity of the brain tissue is located below the head, the brain tissue can obliquely droop under the action of gravity, a certain gap can be reserved between the brain tissue and the skull, and the subsequent retraction operation gap is convenient.
As an improvement of the technical scheme, the regulating method of the cerebral blood comprises the steps of regulating the partial pressure of carbon dioxide, regulating and controlling the anesthesia depth and injecting 20% mannitol; the regulating method of the hydrocephalus comprises lumbar effusion drainage; the hydrocephalus is regulated in a manner of draining hydrocephalus outwards from the waist, so that the hydrocephalus and cerebral blood are at the lower limit of a normal value, the discharge amount of blood and hydrocephalus in subsequent operations is reduced, and the operation is convenient.
As an improvement of the above technical solution, the S1 includes:
s1.1, preparation of surgical operation:
s1.2, judging the position of the lesion tissue: judging the position of the lesion tissue, in particular, the lesion tissue is positioned inside or outside the brain tissue: the reason for the judgment is that different positions correspond to different operation modes;
when the lesion tissue is positioned outside the brain tissue, the lesion position can be quickly seen, the operation is simple and convenient, the brain gap does not need to be opened in an auxiliary manner, and the operation path can be directly and quickly determined;
when the lesion tissue is inside the brain tissue, the lesion site cannot be seen at first, requiring a combination of ways to open the brain space.
S1.2.1, the position of the lesion tissue is positioned outside the brain tissue:
sequentially cutting the scalp, the skull and the meninges, and entering S2.2;
s1.2.2, the location of the lesion tissue is within the brain tissue:
sequentially incising scalp, skull and meninges;
the superficial brain tissue is incised to form a brain space, and the brain space enters S2.1.
As an improvement of the above technical solution, the following steps need to be continuously performed in the process of S1-S2:
covering brain cotton and gelatin sponge on the exposed brain tissue; the brain cotton and the gelatin sponge can play a good role in blood suction and hemostasis, and the condition that the operation process of a doctor is influenced by too much blood gushing in the whole operation process is ensured;
observing the flowing condition of the liquid in the liquid absorption rod 1 through the transparent tube 12, and adjusting the liquid absorption rod 1 according to the flowing condition; the suction device is used for ensuring the stability of the whole liquid suction process, can adjust suction force in real time according to the flowing condition of liquid and avoids the influence on brain tissues caused by overlarge suction force; when the blockage occurs, the blockage can be found in time, and the blockage is prevented from being accumulated too much.
Example 1:
when the lesion tissue site is outside the brain tissue:
s1, after the position of the lesion tissue is determined, sequentially incising the scalp, the skull and the meninges; wherein the brain incision is made up of the space between the brain tissue and the skull at that time; the brain gap can be formed rapidly, the operation path is determined, and the doctor can perform the operation of the operation gap along the brain gap.
S2, extending the liquid absorbing rod 1 into the preliminary gap; the index finger and the middle finger of the doctor exert force on the side, away from the skull, of the liquid suction rod 1, and the thumb abuts against the liquid suction rod 1; such that a gap between the brain tissue and the skull is increased, the preliminary gap transforming into a surgical gap; the handheld liquid suction rod 1 continuously lacerates the brain tissue of the brain incision so as to enable the operation gap to continuously extend inwards to be close to the pathological change tissue, and the operation gap can be stopped when reaching the pathological change tissue; meanwhile, the liquid suction rod 1 is utilized to retract the brain tissue and suck blood, effusion and tissue at the brain incision, so that an operation gap with a required width is exposed between the brain tissue and the skull in the brain incision;
the following steps need to be continuously carried out in the process of S1-S2:
covering brain cotton and gelatin sponge on the exposed brain tissue; in addition, the flowing condition of the liquid in the liquid suction rod 1 is observed through the transparent tube 12, and the liquid suction rod 1 is adjusted according to the flowing condition; when the liquid in the liquid suction rod 1 flows smoothly and unimpededly, the normal liquid suction operation is kept; when the liquid suction rod 1 is blocked, the liquid suction is suspended firstly, and the operation is continued after the tissue is sucked away; the observation is also simple, and in normal operation, the tube 12 is observed under the eye glance sideways at.
When the surgical space reaches the diseased tissue, the surgical knife, bipolar coagulation, aspirator, and other devices may be used to perform the resection.
After the operation is finished, the first tube body 11, the observation tube 12 and the third tube body 13 are unscrewed and detached, residual tissues and liquid inside the first tube body are cleaned, and then the first tube body is sterilized.
Example 2:
when the lesion tissue site is inside the brain tissue:
s1, after the position of the lesion tissue is determined, sequentially cutting the scalp, the skull and the meninges, and cutting the superficial brain tissue to form a brain gap;
s2, adjusting the body position of the patient to enable the head to incline downwards, wherein the horizontal distance between the head and the heart is larger than 10 cm; the body position of the patient is adjusted, so that the body of the patient is horizontal, the head is inclined downwards to form an angle of 30 degrees, the horizontal distance between the head and the heart is larger than 10cm, the center of gravity of brain tissue is positioned below the head, the brain tissue can be inclined and sagged under the action of gravity, a certain gap can be reserved between the brain tissue and a brain shell, and the gap is convenient for a subsequent retraction operation; the blood volume in the brain is reduced by utilizing the method of regulating the partial pressure of carbon dioxide, the depth of anesthesia and injecting 20 percent mannitol, so that the operation process is prevented from being influenced by excessive blood; the needle tube is inserted into the waist of a patient, and the effusion is adjusted in a mode of leading the hydrocephalus outwards, so that the hydrocephalus and the cerebral blood are in the lower limit of the normal value, the discharge amount of the blood and the hydrocephalus in the subsequent operation is reduced, and the operation is convenient.
The liquid absorbing rod 1 is extended into the preliminary gap; the index finger and the middle finger of the doctor exert force on the side, away from the skull, of the liquid suction rod 1, and the thumb abuts against the liquid suction rod 1; such that a gap between the brain tissue and the skull is increased, the preliminary gap transforming into a surgical gap; the handheld liquid suction rod 1 continuously lacerates the brain tissue of the brain incision so as to enable the operation gap to continuously extend inwards to be close to the pathological change tissue, and the operation gap can be stopped when reaching the pathological change tissue; meanwhile, the liquid suction rod 1 is utilized to retract the brain tissue and suck blood, effusion and tissue at the brain incision, so that an operation gap with a required width is exposed between the brain tissue and the skull in the brain incision;
the following steps need to be continuously carried out in the process of S1-S2:
covering brain cotton and gelatin sponge on the exposed brain tissue; in addition, the flowing condition of the liquid in the liquid suction rod 1 is observed through the transparent tube 12, and the liquid suction rod 1 is adjusted according to the flowing condition; when the liquid in the liquid suction rod 1 flows smoothly and unimpededly, the normal liquid suction operation is kept; when the liquid suction rod 1 is blocked, the liquid suction is suspended firstly, and the operation is continued after the tissue is sucked away; the observation is also simple, and in normal operation, the tube 12 is observed under the eye glance sideways at.
When the surgical space reaches the diseased tissue, the surgical knife, bipolar coagulation, aspirator, and other devices may be used to perform the resection.
After the operation is finished, the first tube body 11, the observation tube 12 and the third tube body 13 are unscrewed and detached, residual tissues and liquid inside the first tube body are cleaned, and then the first tube body is sterilized.
In addition to the above examples, further, during surgery, continuous drainage of the lumbar cistern is performed as necessary, but care is taken not to over drain, the continuous drainage should be open after the dura mater is incised, flow rate control is taken, and drainage is closed after proper exposure is achieved; the intra-operative blood pressure is kept as much as possible at the patient pre-operative basal blood pressure level; if necessary, using neuroelectrophysiology and cerebral oxygen monitoring, and appropriate blood gas CO2Controlling the partial pressure to be 25-30 mmHg; in the operation process, the operation space and the increase of the appearance are obtained by cerebrospinal fluid release, the action of gravity of the brain, intratumoral decompression, posture change and other methods, and the gelatin sponge and the brain cotton sheet are used for protecting the brain tissue and absorbing blood and brain tissue fluid;
after the above-mentioned no-pull microsurgical operation, the following should be noted post-operatively: performing conventional skull CT rechecking within 6 hours after the surgical anesthesia is finished, and rechecking the skull within 48 hours after the surgery; to monitor the occurrence of intracranial hematoma and edema; mannitol and other dehydration intracranial pressure reducing medicines are used as appropriate, but are not used as much as possible; performing routine postoperative neurosurgery nursing, and paying attention to whether complications occur or not; repeatedly checking the cranial magnetic resonance flat scan and enhancing as much as possible within 72 hours after operation, and performing Flair or DWI examination if necessary to evaluate the conditions of postoperative cerebral edema, tumor resection and the like; follow-up visits at outpatient visits of 1 month, 3 months and 6 months, and reexamination of CT or skull magnetic resonance flat scanning and enhancement and the like.
The above description is only for the purpose of illustrating the preferred embodiments of the present invention and is not to be construed as limiting the invention, and any modifications, equivalents and improvements made within the spirit and principle of the present invention are intended to be included within the scope of the present invention.
Claims (10)
1. A retracting and cleaning device for brain surgery comprises a liquid suction rod (1), wherein a first supporting plate (2) for supporting a thumb is arranged on the outer wall of the liquid suction rod (1); the method is characterized in that: the supporting mechanism (3) is arranged on the side wall, away from the first supporting plate (2), of the liquid absorbing rod (1), and the supporting mechanism (3) is used for supporting the index finger of a user; the bottom of the supporting mechanism (3) is provided with a third supporting plate (4), and the third supporting plate (4) is used for supporting the middle finger.
2. The surgical retraction cleaning device for brain according to claim 1 characterized in that: the supporting mechanism (3) comprises a supporting part and a second supporting plate (33), one end of the supporting part is fixedly connected with the liquid sucking rod (1), the other end of the supporting part is rotatably connected with the second supporting plate (33), the second supporting plate (33) is used for supporting a forefinger, and the second supporting plate (33) is positioned at the top of the first supporting plate (2); the cross section of the second supporting plate (33) is arc-shaped, and the second supporting plate (33) protrudes towards one side of the liquid absorbing rod (1).
3. The surgical retraction cleaning device for brain according to claim 2, characterized in that: the supporting part comprises a supporting seat (31) and a connecting column (32), the supporting seat (31) is vertically fixed with the liquid absorbing rod (1), a limiting groove (311) is formed in the supporting seat (31), a spherical connector (321) is arranged at one end of the connecting column (32), the connector (321) is rotatably embedded into the limiting groove (311), and the other end of the connecting column (321) is connected with the second supporting plate (33).
4. The surgical retraction and cleaning device for brain according to claim 2 or 3, characterized in that: the supporting mechanism further comprises a flexible contact piece (34), and the flexible contact piece (34) is arranged on the inner walls of the second supporting plate (33) and the limiting groove (311).
5. A surgical retraction and cleaning device for brain according to any of claims 1 to 3, characterized in that: the liquid absorption rod (1) comprises a first pipe body (11), a transparent pipe (12) and a second pipe body (13) which are sequentially connected, and the first pipe body (11) and the second pipe body (13) are respectively assembled and connected to the two ends of the transparent pipe (12).
6. Use method of the retracting and cleaning device applied to any one of the claims 1-5 for brain surgery, which is characterized in that: the method comprises the following steps:
s1, making a brain incision;
s2, performing distraction cleaning on the brain incision;
s2.1, forming a preliminary gap between the brain tissue and the skull in the brain incision by using an auxiliary means;
s2.2, retracting the brain tissue:
s2.2.1, assembling and holding the liquid absorbing rod (1): assembling the first pipe body (11), the observation pipe (12) and the second pipe body (13) after cleaning and sterilization to form a liquid absorption rod (1); the liquid suction rod (1) is held in a pen holding state, so that a thumb is placed on the first supporting plate (2), a forefinger is placed on the supporting mechanism (3), and a middle finger is placed on the third supporting plate (4);
s2.2.2, extending the liquid absorbing rod into the preliminary gap;
s2.2.3, applying a force to the pipette rod (1) on the side facing away from the skull, so that the gap between the brain tissue and the skull increases, the preliminary gap transforming into an operative gap; and the liquid suction rod (1) is utilized to clean blood, effusion and tissues at the operation gap.
7. The use method of the retracting and cleaning device for brain surgery as claimed in claim 6, wherein: s2.1 specifically comprises: regulating the hydrocephalus and the cerebral blood to ensure that the hydrocephalus and the cerebral blood are in the lower limit of normal values; the position of the patient is adjusted so that the head is inclined downwards and the horizontal distance between the head and the heart is more than 10 cm.
8. The use method of the retracting and cleaning device for brain surgery as claimed in claim 7, is characterized in that: the regulating method of the cerebral blood comprises the steps of regulating and controlling the partial pressure of carbon dioxide and the depth of anesthesia and injecting 20% mannitol; the regulating method of hydrocephalus comprises lumbar effusion drainage.
9. The use method of the retracting and cleaning device for brain surgery as claimed in claim 6, wherein: the S1 includes:
s1.1, preparation of surgical operation:
s1.2, judging the position of the lesion tissue:
s1.2.1, the position of the lesion tissue is positioned outside the brain tissue:
sequentially cutting the scalp, the skull and the meninges, and entering S2.2;
s1.2.2, the location of the lesion tissue is within the brain tissue:
sequentially incising scalp, skull and meninges;
the superficial brain tissue is incised to form a brain space, and the brain space enters S2.1.
10. The use method of the retracting and cleaning device for brain surgery as claimed in claim 9, wherein: the processes of S1-S2 need to be carried out without interruption:
covering brain cotton and gelatin sponge on the exposed brain tissue;
observing the flowing condition of liquid in the liquid absorption rod (1) through a transparent tube (12), and adjusting the liquid absorption rod (1) according to the flowing condition.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201911007335.5A CN110882019B (en) | 2019-10-22 | 2019-10-22 | Retracting and cleaning device for brain surgery and using method thereof |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201911007335.5A CN110882019B (en) | 2019-10-22 | 2019-10-22 | Retracting and cleaning device for brain surgery and using method thereof |
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| CN110882019A true CN110882019A (en) | 2020-03-17 |
| CN110882019B CN110882019B (en) | 2021-04-30 |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN112190782A (en) * | 2020-10-10 | 2021-01-08 | 刘文婷 | General surgery department operation wound nursing instrument |
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| CN109865186A (en) * | 2017-12-02 | 2019-06-11 | 山东朱氏药业集团有限公司 | A kind of brain suction tube |
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| US4666451A (en) * | 1986-06-16 | 1987-05-19 | Samaria Carlos E E | Clamp to be actuated by a hand prothesis |
| US8434954B2 (en) * | 2008-07-10 | 2013-05-07 | Scalpal Llc | Handle for writing instruments |
| CN203539392U (en) * | 2013-11-12 | 2014-04-16 | 王波 | Hoffman pulling hook structure |
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| CN110882019B (en) | 2021-04-30 |
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