CN112587204A - Auxiliary device suitable for constructing subcutaneous tunnel in lumbar cisterna magna abdominal cavity shunt operation - Google Patents

Auxiliary device suitable for constructing subcutaneous tunnel in lumbar cisterna magna abdominal cavity shunt operation Download PDF

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Publication number
CN112587204A
CN112587204A CN202011383881.1A CN202011383881A CN112587204A CN 112587204 A CN112587204 A CN 112587204A CN 202011383881 A CN202011383881 A CN 202011383881A CN 112587204 A CN112587204 A CN 112587204A
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Prior art keywords
strip
constructing
hole
auxiliary device
subcutaneous tunnel
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CN202011383881.1A
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Chinese (zh)
Inventor
方旭昊
邓尧
毛仁玲
舒卫权
马慧
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Huadong Hospital
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Huadong Hospital
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3415Trocars; Puncturing needles for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0194Tunnelling catheters
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B2017/320044Blunt dissectors
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B2017/320056Tunnelers

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Veterinary Medicine (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Hematology (AREA)
  • Anesthesiology (AREA)
  • Pulmonology (AREA)
  • Biophysics (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Pathology (AREA)
  • External Artificial Organs (AREA)

Abstract

The invention discloses an auxiliary device suitable for constructing a subcutaneous tunnel in a lumbar cisterna magna abdominal cavity shunt operation, which comprises a through strip part, an elliptical disc part and a handle, wherein the elliptical disc part is connected to the through strip part in a sliding manner, a drainage groove is arranged on the elliptical disc part, and the opening direction of the drainage groove is consistent with the length direction of the through strip part; the handle is located the one end of logical strip portion, and the other end of logical strip portion is equipped with the through-hole, and the axial of through-hole is perpendicular with logical strip portion place central line, and the axial direction of through-hole is unanimous with the degree of depth direction of drainage groove. The invention has safe operation and strong functionality, and can be widely applied to the technical field of medical instruments.

Description

Auxiliary device suitable for constructing subcutaneous tunnel in lumbar cisterna magna abdominal cavity shunt operation
Technical Field
The invention relates to the technical field of medical instruments, in particular to an auxiliary device suitable for constructing a subcutaneous tunnel in a lumbar cisterna abdominal cavity shunt operation, which has the advantages of convenience, rapidness, safety, easy operation, low turnover incidence rate of a postoperative shunt pump, easy cleaning, repeated utilization, convenient postoperative pressure regulation and the like.
Background
Hydrocephalus is the progressive dilatation of the ventricular system caused by absorption disorder, circulation obstruction or hypersecretion of cerebrospinal fluid due to various reasons, and pressing force can be divided into high intracranial pressure hydrocephalus and normal pressure hydrocephalus. The typical symptoms of hydrocephalus are headache, balance disorder or gait instability, urinary incontinence, progressive decline of intelligence and progressive reduction of autonomic body movement, and can be clinically diagnosed by lumbar puncture drainage test. Once hydrocephalus is diagnosed definitely, LPS (lumbar cisternal abdominal shunt) has definite curative effect for such patients, is relatively safe without cranial cavity operation, and can be used as an alternative to ventricular abdominal shunt (VPS). Over the years of clinical use, the following problems have gradually emerged:
(1) the relatively sharp subcutaneous tunnel constructed by the traditional thick needle often causes that the subcutaneous tunnel and the shunt pump are not on the same plane, thus causing the epidermis to be damaged or directly penetrating into the abdominal cavity;
(2) in the traditional operation, a subcutaneous tunnel is constructed by utilizing a hollow coarse needle, and a shunt tube is led out through the hollow structure of the coarse needle, but the cleaning after the operation is difficult due to the particularity of the hollow structure;
(3) in the traditional operation, subcutaneous tissues are separated by blunt bending forceps for placing a shunt pump, so that the size of a separated space is not matched with that of the shunt pump; the separation space is too large, so that the shunt pump has a larger free space, and the shunt pump is easy to turn over after operation to influence the shunt effect; the separation space is too small, so that the difficulty of arranging the shunt pump in the operation is increased;
(4) traditional operation often leads to the shunt pump to be located directly below subcutaneous incision, and the scar that the incision formed often influences postoperative magnetic pressure regulation.
Disclosure of Invention
Aiming at the problems, the invention provides an auxiliary device suitable for constructing a subcutaneous tunnel in an LPS (low-pressure plasma) operation, which has the functions of convenience, rapidness, safety, easy operation, low turnover incidence rate of a postoperative shunting pump, easy cleaning and repeated utilization and convenient and fast postoperative pressure regulation.
In order to achieve the purpose, the invention adopts the technical scheme that:
an auxiliary device suitable for constructing a subcutaneous tunnel in a lumbar cisterna abdominal cavity shunt operation comprises a through strip portion, an elliptical disc portion and a handle, wherein the elliptical disc portion is connected to the through strip portion in a sliding mode, a drainage groove is formed in the elliptical disc portion, and the opening direction of the drainage groove is consistent with the length direction of the through strip portion; the handle is located the one end of logical strip portion, the other end of logical strip portion is equipped with the through-hole, the axial of through-hole is perpendicular with logical strip portion place central line, just the axis direction of through-hole is unanimous with the degree of depth direction of drainage groove.
Furthermore, the through-bar part is a flat bar-shaped structure, and one end part close to the through-hole is a structure with an arc-shaped cross section.
Furthermore, the cross section of the elliptic disc part is elliptic, a sliding groove for movably clamping the connecting bar part is arranged on the elliptic disc part, and the sliding groove is parallel to the drainage groove.
Furthermore, the oval plate part comprises an oval plate main body, and the sliding groove penetrates through the center of the plate main body and extends along the long side direction of the oval plate main body; the drainage grooves extend to the sliding groove positions from the front side of the tray main body in the longitudinal direction and are communicated with the sliding grooves.
Further, the drainage groove is groove-shaped and extends from one end of the tray main body to the other end; the cross section of the sliding groove is the same as that of the through strip portion.
Further, the grip is fixedly connected to the clear bar portion and extends along the clear bar portion in a manner that the width gradually increases.
Furthermore, the end face of one end, close to the through hole, of the through strip portion is arc-shaped, and the arc direction where the end face is located is consistent with the width direction of the drainage groove.
Compared with the prior art, the invention has the advantages that:
(1) the oval disc part is designed to integrally accord with the strip-shaped structures of the liquid storage bag and the shunt valve, when an operator constructs a subcutaneous tunnel from an incision of a front superior iliac spine to a reverse Mains point, a cavity slightly larger than the structures of the liquid storage bag and the shunt valve is formed through blunt separation of the oval disc part, the phenomenon that the shunt structure overturns to influence the shunt effect after the operation due to overlarge cavity is avoided, and the phenomenon that the difficulty of placing the liquid storage bag and the shunt valve is increased in the operation due to the overlarge cavity is avoided;
(2) the invention effectively moves the liquid storage bag and the shunt valve out of the position right below the incision of the anterior superior iliac spine, thereby avoiding the influence of the operation scar at the incision after operation on the magnetic pressure regulating effect;
(5) compared with the traditional sharp hollow needle-shaped structure, the detachable separation structure and the drainage groove of the through bar part and the elliptic disc part are beneficial to cleaning and disinfection after operation.
Drawings
FIG. 1 is a first perspective view of an embodiment of the present invention;
FIG. 2 is a second perspective view of the embodiment of the present invention;
fig. 3 is a front view of an embodiment of the present invention.
Detailed Description
The present invention is described in further detail below with reference to figures 1-3.
Example one
In the present example, preferred embodiments of the present invention are specifically illustrated.
An auxiliary device suitable for constructing a subcutaneous tunnel in a lumbar cisterna abdominal cavity shunt comprises a through strip portion 6, an elliptical disc portion and a handle 1, wherein the elliptical disc portion is connected to the through strip portion 6 in a sliding mode, a drainage groove 2 is formed in the elliptical disc portion, and the opening direction of the drainage groove 2 is consistent with the length direction of the through strip portion 6; the handle 1 is located one end of poker portion 6, and the other end of poker portion 6 is equipped with through-hole 3, and the axial of through-hole 3 is perpendicular with poker portion 6 place central line, and the axial direction of through-hole 3 is unanimous with the degree of depth direction of drainage groove 2.
In the specific implementation process, through addding drainage groove 2, can realize postoperative washing and sterile function, the practicality is strong. And the removable connection between oval disc portion and poker portion 6 can reach the purpose of dismantling or assembling this device in a flexible way according to different medical operation processes, and is functional strong.
The through-bar portion 6 is formed in a flat bar-like structure, and one end portion thereof near the through-hole 3 is formed in a structure having an arc-shaped cross section.
Compared with the traditional sharp hollow needle-shaped structure, the whole poker part 6 is flat and flat, which is beneficial to keeping the subcutaneous tunnel and the shunt pump in the same horizontal plane and avoiding damaging the epidermis by passing shallow or directly penetrating into the abdominal cavity by passing deep.
The cross section of the elliptic disc part is elliptic, a sliding groove 4 for movably clamping the bar part 6 is arranged on the elliptic disc part, and the sliding groove 4 is parallel to the drainage groove 2.
By additionally arranging the sliding groove 4 on the oval disc part, the oval disc part can be detached according to actual conditions, and a subcutaneous tunnel from the anterior superior iliac spine to a lumbar puncture point is constructed by using the through strip part 6.
The oval plate part comprises an oval plate main body 5, and the sliding chute 4 penetrates through the center of the plate main body 5 and extends along the long side direction of the oval plate main body 5; the drainage grooves 2 extend in the longitudinal direction from the front side of the tray main body 5 to the positions of the sliding grooves 4, and communicate with the sliding grooves 4.
Structurally, the elliptic disc part comprises an elliptic disc main body 5, a sliding groove 4 passing through the central position of the disc main body 5 is formed in the disc main body 5 along the long side direction of the ellipse, and a through strip part 6 is arranged in a penetrating way by the sliding groove 4; the drainage groove 2 is a strip-shaped gap which is communicated with the sliding groove 4 and has the opening direction consistent with the opening direction, and the gap is positioned at the center of the disc main body 5.
The drainage groove 2 is groove-shaped and extends from one end of the tray main body 5 to the other end; the cross-sectional shape of the runner 4 is the same as the cross-sectional shape of the poker portion 6.
The grip 1 is fixed to the continuous portion 6 and extends along the continuous portion 6 so as to gradually increase in width.
The handle 1 is provided with an arc transition 7 at the position connected with the poker part 6, and the handle 1 becomes wider gradually in the length direction, so that the practicability is strong.
The end face of one end of the through strip part 6, which is close to the through hole 3, is arc-shaped, and the arc direction of the end face is consistent with the width direction of the drainage groove 2.
Through setting up the terminal surface of poker 6 to the arc shape, be favorable to reducing intraoperative hemorrhage or other collateral damage when carrying out blunt nature and getting through subcutaneous tunnel.
Example two
In this embodiment, the usage and process of the present device are specifically described.
The patient selects the right lateral position;
selecting L3-4 intervertebral space as puncture point, cutting skin 3mm at the puncture point, placing puncture needle, and draining clarified cerebrospinal fluid;
placing the puncture needle into the lumbar cisterna magna end to reach 7cm of the subarachnoid cavity, checking the smoothness degree of the shunt tube, and pulling out the lumbar puncture needle;
cutting skin 2cm at anterior superior iliac spine, separating subcutaneous tissue, and making tunnel from the anterior superior iliac spine to lumbar vertebra via the strip-passing part 6;
the lumbar cisterna magna shunt pipe passes through a through hole 3 about 2cm at the head end of the through strip part 6, the through strip part 6 with the shunt pipe is pulled back to the incision of the anterior superior iliac spine along the original tunnel, and the through strip part is clamped for standby;
cutting skin 2cm at trans-Mai's point, separating to abdominal cavity, placing into abdominal cavity end shunt tube, and stitching purse-string for use;
placing a poker part 6 for assembling an oval disc part into an incision at the anterior superior iliac spine, and bluntly constructing a subcutaneous tunnel in the direction of a reverse Mains point incision until the tail end of the oval disc part is immersed into an incision of the skin of the anterior superior iliac spine;
the shunt tube at the abdominal cavity end passes through the through hole at the head end of the through strip part 6 of the invention by about 2cm, the through strip part 6 with the shunt tube is pulled back to the incision at the anterior superior iliac spine along the original tunnel, and the through strip part is clamped for standby;
trimming the lengths of the two shunt tubes, respectively connecting the liquid storage bag and the shunt valve, checking the smoothness of the shunt system, and knotting a purse-string suture to fix the shunt tube at the abdominal cavity end;
the reservoir and shunt are embedded into the cavity formed by the oval disk part in the subcutaneous tunnel from the anterior superior iliac spine to the reverse Mains point, and the skin incision is sutured.
The present invention and its embodiments have been described above, and the description is not intended to be limiting, and the drawings are only one embodiment of the present invention, and the actual structure is not limited thereto. In summary, those skilled in the art should appreciate that they can readily use the disclosed conception and specific embodiments as a basis for designing or modifying other structures for carrying out the same purposes of the present invention without departing from the spirit and scope of the invention as defined by the appended claims.

Claims (7)

1. The auxiliary device is suitable for constructing a subcutaneous tunnel in the lumbar cisterna magna abdominal cavity shunt operation and is characterized by comprising a through strip part, an elliptical disc part and a handle, wherein the elliptical disc part is connected to the through strip part in a sliding manner, a drainage groove is arranged on the elliptical disc part, and the opening direction of the drainage groove is consistent with the length direction of the through strip part; the handle is located the one end of logical strip portion, the other end of logical strip portion is equipped with the through-hole, the axial of through-hole is perpendicular with logical strip portion place central line, just the axis direction of through-hole is unanimous with the degree of depth direction of drainage groove.
2. The device as claimed in claim 1, wherein the through-bar portion is a flat bar structure, and an end portion near the through-hole is an arc-shaped cross-section structure.
3. The auxiliary device for constructing the subcutaneous tunnel in the lumbar cisterna abdominalis shunt according to claim 1, wherein the cross section of the oval disk part is oval, the oval disk part is provided with a sliding groove for movably clamping the connecting strip part, and the sliding groove and the drainage groove are parallel to each other.
4. The auxiliary device for constructing the subcutaneous tunnel in the lumbar cisterna abdominal bypass surgery as claimed in claim 3, wherein the elliptical disk portion comprises an elliptical disk main body, the sliding chute penetrates through the center of the disk main body and extends along the long side direction of the ellipse where the disk main body is located; the drainage grooves extend to the sliding groove positions from the front side of the tray main body in the longitudinal direction and are communicated with the sliding grooves.
5. The auxiliary device for constructing the subcutaneous tunnel in the lumbar cisterna abdominalis shunt according to claim 4, wherein the drainage grooves are grooved and extend from one end of the tray body to the other end; the cross section of the sliding groove is the same as that of the through strip portion.
6. The aid device according to claim 1, wherein the handle is secured to the portion of the shaft and extends along the portion of the shaft in a width-increasing manner.
7. The auxiliary device for constructing the subcutaneous tunnel in the lumbar cisterna abdominal bypass surgery as claimed in any one of claims 1 to 6, wherein the end surface of the through strip portion close to the through hole is arc-shaped, and the arc direction of the end surface is consistent with the width direction of the drainage groove.
CN202011383881.1A 2020-12-01 2020-12-01 Auxiliary device suitable for constructing subcutaneous tunnel in lumbar cisterna magna abdominal cavity shunt operation Pending CN112587204A (en)

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CN202011383881.1A CN112587204A (en) 2020-12-01 2020-12-01 Auxiliary device suitable for constructing subcutaneous tunnel in lumbar cisterna magna abdominal cavity shunt operation

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Citations (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN2134166Y (en) * 1992-08-15 1993-05-26 中国人民解放军第88医院 Subcutaneous tunnel poker
CN201624691U (en) * 2010-01-19 2010-11-10 付鹏 Novel subcutaneous tunnel poker
CN202604904U (en) * 2012-04-16 2012-12-19 林少华 Ventricle-peritoneal shunt cleaning rod
CN103735295A (en) * 2013-12-26 2014-04-23 暨南大学 Subcutaneous bent separating rod for transoral-vestibule endoscopy thyroid surgery
US20150374889A1 (en) * 2014-06-27 2015-12-31 Harrison M. Lazarus Surgical kits for body cavity drainage and related methods
CN205322382U (en) * 2016-02-01 2016-06-22 中国医科大学附属盛京医院 Poker is used in reposition of redundant personnel operation of split type ventricles of brain abdominal cavity
CN205359526U (en) * 2016-02-01 2016-07-06 中国医科大学附属盛京医院 Individuation ventricles of brain abdominal cavity subcutaneous tunnel of reposition of redundant personnel operation poker
CN205515948U (en) * 2016-02-01 2016-08-31 中国医科大学附属盛京医院 Reposition of redundant personnel operation of ventricles of brain abdominal cavity is with integrated subcutaneous tunnel poker
CN108514442A (en) * 2018-04-23 2018-09-11 丽水市人民医院 A kind of visualization Ventriculo peritoneal shunt pipe embedded device and its application method
CN209863917U (en) * 2018-12-28 2019-12-31 董志强 Medulla Tetrapanacis for ventriculoperitoneal shunt operation
CN211300114U (en) * 2019-12-18 2020-08-21 山西医科大学 Subcutaneous tunnel poker for ventriculoperitoneal shunt

Patent Citations (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN2134166Y (en) * 1992-08-15 1993-05-26 中国人民解放军第88医院 Subcutaneous tunnel poker
CN201624691U (en) * 2010-01-19 2010-11-10 付鹏 Novel subcutaneous tunnel poker
CN202604904U (en) * 2012-04-16 2012-12-19 林少华 Ventricle-peritoneal shunt cleaning rod
CN103735295A (en) * 2013-12-26 2014-04-23 暨南大学 Subcutaneous bent separating rod for transoral-vestibule endoscopy thyroid surgery
US20150374889A1 (en) * 2014-06-27 2015-12-31 Harrison M. Lazarus Surgical kits for body cavity drainage and related methods
CN205322382U (en) * 2016-02-01 2016-06-22 中国医科大学附属盛京医院 Poker is used in reposition of redundant personnel operation of split type ventricles of brain abdominal cavity
CN205359526U (en) * 2016-02-01 2016-07-06 中国医科大学附属盛京医院 Individuation ventricles of brain abdominal cavity subcutaneous tunnel of reposition of redundant personnel operation poker
CN205515948U (en) * 2016-02-01 2016-08-31 中国医科大学附属盛京医院 Reposition of redundant personnel operation of ventricles of brain abdominal cavity is with integrated subcutaneous tunnel poker
CN108514442A (en) * 2018-04-23 2018-09-11 丽水市人民医院 A kind of visualization Ventriculo peritoneal shunt pipe embedded device and its application method
CN209863917U (en) * 2018-12-28 2019-12-31 董志强 Medulla Tetrapanacis for ventriculoperitoneal shunt operation
CN211300114U (en) * 2019-12-18 2020-08-21 山西医科大学 Subcutaneous tunnel poker for ventriculoperitoneal shunt

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