CN113081181B - Intervertebral disc resectoscope - Google Patents

Intervertebral disc resectoscope Download PDF

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Publication number
CN113081181B
CN113081181B CN202110507472.6A CN202110507472A CN113081181B CN 113081181 B CN113081181 B CN 113081181B CN 202110507472 A CN202110507472 A CN 202110507472A CN 113081181 B CN113081181 B CN 113081181B
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Prior art keywords
cutting
discectomy
knocking
cutting tube
discectomy device
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CN202110507472.6A
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CN113081181A (en
Inventor
姜帅
王承夏
李卓夫
李危石
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Peking University Third Hospital Peking University Third Clinical Medical College
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Peking University Third Hospital Peking University Third Clinical Medical College
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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
    • A61B17/32Surgical cutting instruments
    • A61B17/3205Excision instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B2017/320064Surgical cutting instruments with tissue or sample retaining means

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

The invention relates to a discectomy device, which comprises a knocking post and a cutting tube, wherein the cutting tube is fixedly arranged at one end part of the knocking post, and central axes of the knocking post and the cutting tube are overlapped; the cutting tube is internally provided with a hollow duct extending along a central axis; the hollow pore canal penetrates through the knocking column and the cutting pipe; the cross sections of the cutting pipe and the hollow pore canal are square; the end part of the cutting tube, which is far away from the knocking column, is provided with a knife edge, wherein the knife edge is provided with inward knife edges which incline towards the inside of the hollow pore canal, and the inward knife edge openings are distributed on four edges of the square cross section of the cutting tube. The intervertebral disc resectoscope can solve the tedious steps of cutting four sides one by one in a chisel hammer mode, can tidy the resected edges and clear the operation field of view, avoids the tedious process of taking out resected intervertebral disc fragments once, and can avoid unexpected damage caused by sharp edges of a surgical knife or a osteotome in the cutting process.

Description

Intervertebral disc resectoscope
Technical Field
The invention relates to the technical field of medical appliances, in particular to a discectomy device.
Background
The most traditional old method for cutting the fibrous ring of the outer layer of the intervertebral disc is still used for solving the problem at present, namely, the fibrous ring with serious calcification or ossification is cut by a traditional scalpel, the fibrous ring cannot be cut by the scalpel smoothly, and even peripheral important nerves and dura mater are possibly damaged due to the loss of hands in the process of exerting effort, at the moment, the main method is to cut gradually along the upper, lower, left and right edges of the intervertebral disc by using the osteotome, but the method has the defects that the edges of the ossified intervertebral disc are needed to be confirmed in each cutting, the vertebral cortex is damaged to cause more bleeding when the range is too large, the cutting range cannot be satisfied when the range is too small, the cutting range is needed to be enlarged again, the operation is time-consuming and labor-consuming, and the damage risk in the operation is increased.
As can be seen by examining the relevant literature and patents, there are fewer simple instruments for discectomy, the closest instrument being shown in FIG. 1. Fig. 1 shows a lumbar disc extractor, which mainly comprises an outer sleeve 3 and an inner sleeve 2, wherein the top end of the outer sleeve is connected with a handle 6, the bottom is fixedly connected with a supporting frame 5, the top of the inner sleeve is fixedly connected with a rotating disc 1, and the bottom is provided with an annular knife 4. When in use, the outer sleeve 3 is placed on the lumbar intervertebral disc which is protruded, the supporting frame 5 arranged at the bottom of the outer sleeve 3 mainly plays a role in supporting and fixing, the handle 6 is held by hands to keep the outer sleeve 3 stable, then the inner sleeve 2 is sleeved in the outer sleeve 3, the rotary disk 1 at the top of the inner sleeve 2 is rotated, the annular knife 4 at the bottom of the inner sleeve 2 is driven to rotate, the protruded lumbar intervertebral disc is cut in, and after the inner sleeve and the outer sleeve are taken out, the cut lumbar intervertebral disc is taken out by the nucleus pulposus forceps.
The lumbar intervertebral disc extractor can cut part of intervertebral disc, but has heavy appearance, blocks the operation view during operation, is complex in operation, can be used only by sleeve nesting, and can not cut the edge of the intervertebral disc neatly, and the rest part outside the annular cutting range still needs to be cleaned by matching with a surgical knife or a bone cutter during cutting.
Disclosure of Invention
The invention aims to provide a novel intervertebral disc resectoscope which can be used for resecting intervertebral discs rapidly, simply, conveniently and safely, and aims to solve the technical problems of how to solve the complex steps of cutting four sides one by one in a chisel hammer mode, the resected edges can be tidied, the operation vision can be clear, the complex step of taking out resected intervertebral disc fragments once is avoided, and the accidental damage caused by sharp edges of a scalpel or a osteotome can be avoided in the cutting process.
The invention aims to solve the defects of the prior art and provides a discectomy device which comprises a knocking post and a cutting tube, wherein the cutting tube is fixedly arranged at one end part of the knocking post, and central axes of the knocking post and the cutting tube are coincident; the cutting tube is internally provided with a hollow duct extending along a central axis; the hollow pore canal penetrates through the knocking column and the cutting pipe; the cross sections of the cutting pipe and the hollow pore canal are square; the end part of the cutting tube, which is far away from the knocking column, is provided with a knife edge, the knife edge is provided with inward knife edges which incline towards the inside of the hollow pore canal, and the inward knife edges are distributed on four edges of the square cross section of the cutting tube.
Preferably, the cross section of the knocking post is circular.
The diameter of the knocking column is 10mm, and the length of the knocking column is 100mm.
The side length of the outer peripheral wall of the cutting pipe is 5mm, and the side length of the inner peripheral wall of the hollow pore canal is 4mm.
The total length of the discectomy device is 200mm.
The width of the inward knife edge is 0.5mm.
Preferably, the discectomy device includes a plurality of different gauges, the cutting tubes of the different gauges differing in side length.
It is further preferred that the side length of the cutting tube of adjacent gauge discectomy devices is incremented by a predetermined value.
In a preferred embodiment, the side length of the cutting tube of adjacent gauge discectomy devices is sequentially increased in size in a model of 2mm up to 15mm.
Further preferably, the outer contour of the discectomy device is rounded.
Advantageous effects
Compared with the prior art, the invention has the beneficial effects that:
1. after the safe edge of the discectomy is confirmed, the time and the effect of cutting by the four surgical knives are equivalent to each time the discectomy device is knocked, the cutting depth can be kept consistent, the process of searching the edge of the disc annulus is omitted each time, the operation time is shortened, and the operation efficiency is improved.
2. The design of the hollow pore canal in the discectomy device enables the discectomy device to directly collect all the cut broken tissues of the intervertebral disc in the cutting process, so that the broken tissues of the intervertebral disc enter the hollow pore canal of the discectomy device, and the trouble of taking out the broken tissues of the intervertebral disc each time is avoided. And cutting a piece of intervertebral disc fragmentation tissue, and then directly performing next cutting until the cutting process is finished, wherein at the moment, all intervertebral discs blocking the pore channels can be taken out by using a Kirschner wire to pass through the hollow pore channels.
3. The opening of the discectomy device is 5mm square, and the size of each 2mm is increased gradually until 15mm. The use of different sizes of intervertebral space is satisfied in order to reduce the number of resections. A certain range of ablation is met with a minimum number of times.
4. When the discectomy device is used, as four edges of the discectomy device are subjected to fillet treatment and the knife edge design is an inward knife edge, only after the cutting range is covered on the knife edge, the cutting process is realized by knocking the top of the discectomy device after confirming that the cutting range is correct, the whole cutting process can not cause accidental damage of surrounding adjacent soft tissues, the damage risks of peripheral important nerves, dura mater and the like caused by accidental deviation of positions in the process of feeding the surgical knife or the bone knife into the centrum focus or in the knocking process can be avoided, and once the damage happens, the consequences can not be envisaged. This is another advantage of the discectomy device, namely the high safety factor, which reduces the risk of surgery.
5. The discectomy device disclosed by the invention can flexibly grasp the depth and angle of cutting according to the needs, can cut vertically, and can realize certain specific ranges and depths through the inclined direction.
6. The discectomy device can realize the trimming and the clear excision process of the edge of the fibrous ring of the intervertebral disc through the square incision, the clear operation vision is beneficial to the subsequent excision of the nucleus pulposus of the intervertebral disc and the vertebra and fusion of the intervertebral space, and the trimming of the edge of the intervertebral disc is not satisfied by the artificial excision of one time with a surgical knife or a bone knife.
7. The discectomy device has the advantages of simple manufacturing process, low cost, economy, practicability and repeated disinfection and utilization, and can solve the problem of headache of clinical common people without high cost.
Drawings
The accompanying drawings are included to provide a further understanding of the invention and are incorporated in and constitute a part of this specification, illustrate and do not limit the invention.
Fig. 1 is a schematic view of a prior art lumbar disc remover.
Fig. 2 is a schematic view of the configuration of the discectomy device of the present invention.
Fig. 3 is an elevation view of the discectomy device of the present invention.
Fig. 4 is a side view of the discectomy device of the present invention.
Fig. 5 is an elevation view of the disc cutter bottom blade modified to cut a 30 angled blade.
Fig. 6 is an oblique view of the disc cutter bottom blade modified to cut off the 30 oblique blade.
Fig. 7 is an elevation view of the disc cutter bottom blade modified to cut a 45 angled blade.
Fig. 8 is an oblique view of the disc cutter bottom blade modified to cut the 45 oblique blade.
Fig. 9 is an elevation view of the disc cutter bottom blade modified to cut a 60 oblique blade.
Fig. 10 is an oblique view of the disc cutter bottom blade modified to cut the 60 oblique blade.
Detailed Description
The present invention is described in more detail below to facilitate an understanding of the present invention.
As shown in fig. 2 to 4, the discectomy device according to the present invention includes a striking post 1 and a cutting tube 2, wherein the cutting tube 2 is fixedly disposed at one end of the striking post 1, and central axes of the striking post 1 and the cutting tube 2 are coincident; the interior of the cutting tube 2 is provided with a hollow duct 3 extending along a central axis; the hollow pore canal 3 penetrates through the knocking column 1 and the cutting pipe 2; the cross sections of the cutting pipe 2 and the hollow pore canal 3 are square; the end part of the cutting tube 2, which is far away from the knocking column 1, is provided with a knife edge, the knife edge is provided with inward knife edges 4 which incline towards the inside of the hollow pore canal 3, and the inward knife edges 4 are distributed on four sides of the square cross section of the cutting tube 2.
Preferably, the cross section of the knocking post 1 is circular.
The diameter R1 of the knocking column 1 is 10mm, and the length L2 is 100mm.
The side length R2 of the outer peripheral wall of the cutting tube 2 is 5mm, and the side length R3 of the inner peripheral wall of the hollow pore canal 3 is 4mm.
The total length L1 of the discectomy device is 200mm.
The width of the inward knife edge 4 is 0.5mm.
Preferably, the discectomy device includes a plurality of different gauges, the cutting tubes 2 of the different gauges being different in side length.
It is further preferred that the side length of the cutting tube 2 of the adjacent gauge discectomy device is incremented by a predetermined value.
In a preferred embodiment, the side length of the cutting tube 2 of adjacent gauge discectomy devices is sequentially increased in size in a model of 2mm up to 15mm.
It is further preferred that the four sides (i.e., the outer contour) of the discectomy device be rounded.
In another preferred embodiment, the shape of the bottom edge of the discectomy device may be modified, such as by changing the edge to a beveled edge that cuts 30 °, 45 °, 60 ° (as shown in fig. 5-10), to meet the needs of different cutting ranges.
When the discectomy device is used, the discectomy device with proper size is selected according to the height of the pathological change intervertebral disc measured by the preoperative image, so that the cutting frequency is reduced as much as possible in the use process, and the purpose of completing the established excision range in a shorter time is achieved. When the novel discectomy device is used, the pathological change intervertebral space is pulled and exposed, the discectomy device is slowly and carefully avoided from important soft tissue structures until the incision of the discectomy device is aligned to the annulus fibrosus on the pathological change intervertebral disc, the safe excision edge of the intervertebral disc is sought, the edge of the discectomy device is close to the edge of the planned excision, the top end of a knocking column 1 of the discectomy device is knocked outside after confirming that the important dura mater, nerves and other structures are not mixed in the excision scope, the depth of the incision for cutting the intervertebral disc is grasped through the magnitude of knocking force, the time and the effect of four times of scalpel cutting are equivalent to each time of knocking the discectomy device, the cutting depth can be kept consistent, the process of seeking the edge of the disc annulus fibrosus each time is omitted, the operation time is shortened, and the operation efficiency is improved. Meanwhile, as the four sides of the discectomy device are treated by the fillets and the knife edge is designed as an inward knife edge, the whole in-vivo stage and the cutting process can not cause accidental damage of surrounding adjacent soft tissues, and the risk of damage to surrounding important nerves, dura mater and the like caused by accidental deviation of positions in the process of feeding the vertebral body focus or in the knocking process due to sharp edges of a surgical knife or a bone knife in the cutting process can be avoided. With different striking angles (vertical and tiltable) of the discectomy device, the cutting range is different, and the adjustment is changed according to the operation requirement of an operator. In the cutting process, the discectomy device can directly collect all the cut intervertebral disc disintegrated tissues to enable the cut intervertebral disc disintegrated tissues to enter the hollow pore canal of the discectomy device, so that the trouble of taking out the intervertebral disc disintegrated tissues each time is avoided. And cutting a piece of intervertebral disc fragmentation tissue, and directly continuing to cut until the cutting process is finished, wherein at the moment, all intervertebral discs blocking the hollow pore canal can be taken out by using a Kirschner wire to pass through the hollow pore canal. The edge of the intervertebral disc annulus can be cut neatly by utilizing the square crossing cutting, the operation vision is clear, the subsequent excision of the nucleus pulposus of the intervertebral disc and the vertebra and fusion of the intervertebral space are facilitated, and the edge neatly of the intervertebral disc is met as much as possible by not manually cutting once with a surgical knife or a bone knife.
The foregoing describes preferred embodiments of the present invention, but is not intended to limit the invention thereto. Modifications and variations to the embodiments disclosed herein may be made by those skilled in the art without departing from the scope and spirit of the invention.

Claims (5)

1. The discectomy device is characterized by comprising a knocking post and a cutting tube, wherein the cutting tube is fixedly arranged at one end part of the knocking post, and central axes of the knocking post and the cutting tube are coincident; the cutting tube is internally provided with a hollow duct extending along a central axis; the hollow pore canal penetrates through the knocking column and the cutting pipe; the cross sections of the cutting pipe and the hollow pore canal are square; the end part of the cutting tube, which is far away from the knocking column, is provided with a knife edge, the knife edge is provided with inward knife edges which incline towards the inside of the hollow pore canal, and the inward knife edges are distributed on four edges of the square cross section of the cutting tube; the cross section of the knocking column is circular;
the discectomy device comprises a plurality of discectomy devices with different specifications, and the cutting tubes of the discectomy devices with different specifications have different side lengths;
the diameter of the knocking column is 10mm, and the length is 1mm;
the total length of the discectomy device is 200mm;
the external contour of the discectomy device is rounded; when the discectomy device is used, selecting the discectomy device with a proper size according to the height of the pathological change intervertebral disc measured by the preoperative image; during the cutting process, the discectomy device can directly collect all of the disc fragment tissue that is cut off, allowing it to enter the hollow tunnel of the discectomy device.
2. The discectomy device of claim 1, wherein the cutting tube has a peripheral wall of 5mm in length and the hollow tunnel has an inner peripheral wall of 4mm in length.
3. The discectomy device of claim 1, wherein the inward blade has a width of 0.5mm.
4. The discectomy device of claim 1, wherein the cutting tube of adjacent gauge discectomy devices has a side length that is incremented by a predetermined value.
5. The discectomy device of claim 4, wherein the cutting tubes of adjacent gauges of discectomy device are sequentially incremented by a size of 2mm to 15mm.
CN202110507472.6A 2021-05-10 2021-05-10 Intervertebral disc resectoscope Active CN113081181B (en)

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CN113081181B true CN113081181B (en) 2024-02-02

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Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN114343792A (en) * 2022-01-18 2022-04-15 王向前 Posterior longitudinal ligament fiber ring mouth gag of spinal column

Citations (4)

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Publication number Priority date Publication date Assignee Title
CN201658398U (en) * 2010-04-06 2010-12-01 韩明建 Lumbar intervertebral disc extractor
CN201958955U (en) * 2011-01-30 2011-09-07 赵斌 Quadrangular bone knife
CN205548624U (en) * 2016-03-18 2016-09-07 王洪伟 Be used for excising bone knife of ossified focus of lumbar vertebrae way of escape
CN106562813A (en) * 2016-10-28 2017-04-19 邹德威 Intervertebral disc tissue one-time overall cutting and intervertebral space forming cutter

Family Cites Families (3)

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Publication number Priority date Publication date Assignee Title
US6641582B1 (en) * 2000-07-06 2003-11-04 Sulzer Spine-Tech Inc. Bone preparation instruments and methods
US7699849B2 (en) * 2002-01-17 2010-04-20 Concept Matrix, Llc Diskectomy instrument with disposable blade head
US20050090829A1 (en) * 2003-10-23 2005-04-28 Osteotech, Inc. Spinal bone chisels

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN201658398U (en) * 2010-04-06 2010-12-01 韩明建 Lumbar intervertebral disc extractor
CN201958955U (en) * 2011-01-30 2011-09-07 赵斌 Quadrangular bone knife
CN205548624U (en) * 2016-03-18 2016-09-07 王洪伟 Be used for excising bone knife of ossified focus of lumbar vertebrae way of escape
CN106562813A (en) * 2016-10-28 2017-04-19 邹德威 Intervertebral disc tissue one-time overall cutting and intervertebral space forming cutter

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