CN114712572A - Hematoma suction equipment for neurosurgery - Google Patents

Abstract

The invention discloses an intracranial hematoma suction device for neurosurgery, which comprises a suction part and an operation part and is characterized in that: the suction part comprises a pipe body, the pipe body is provided with a hollow working channel, the front end of the pipe body is provided with an ultrasonic detection assembly, a camera shooting illumination assembly and a pressure detection assembly, the rear end of the pipe body is connected with the operation part, and the operation part is provided with a rotary driving mechanism for driving the suction part to rotate and a rotary driving mechanism for driving the camera shooting illumination assembly to rotate; the operating part is provided with a working channel guide pipe capable of moving axially, the head of the working channel guide pipe is bent towards one side, the working channel guide pipe is made of elastic materials, and the operating part further comprises a translation driving mechanism for driving the working channel guide pipe to move axially along the working channel; auxiliary channel pipes are respectively arranged on the left side and the right side of the working channel in the pipe body.

Description

Hematoma suction equipment for neurosurgery

Technical Field

The invention relates to neurosurgery, in particular to equipment in hematoma suction operation in the neurosurgery.

Background

At neurosurgery, when carrying out intracranial hematoma and drive the operation, adopt the suction tube to insert intracranial to hematoma department and carry out the suction to the hematoma outside by the cranium, can integrate at the head of suction tube usually has neural scope, and neural scope can show intracranial image on display device as operative person's "eyes" in real time, provides hematoma intracavity picture for the operative person. However, the conventional neuroendoscopy has the following disadvantages: 1. when removing hematoma, the visual field is often obstructed by blood (e.g., when active bleeding occurs), resulting in reduced visibility and poor imaging quality. 2. Most of the traditional neuroendoscopes with a working channel are observation mirrors with fixed angles (such as KarlStorz Lotta), and endoscopes with variable lens observation angles usually do not have a working channel (such as KarlStorzEndoCAMeleon), so that tissues in the inner side direction of the endoscope are difficult to observe and process simultaneously. If the tissue site to be treated is not in the direction of the current endoscope axis, the endoscope needs to be oscillated to aim its end at the target site, which can "cut" the brain tissue, severely impairing brain function. 3. In the operation of removing the cerebral hematoma, the clearer the hematoma is, the better the hematoma is removed, and sometimes, for some residual hematoma distributed around the blood vessel, the blood vessel can be damaged by removing the residual hematoma blindly, and new active hemorrhage is caused. The traditional neuroendoscopy can only distinguish where hematoma exists in a hematoma cavity, and cannot judge whether the hematoma brings new hemorrhage after being cleared. It is also impossible to determine where there are important blood vessels around the haematoma chamber. 4. Traditional neuroendoscopy does not possess intracranial pressure detection function, when carrying out the single channel (pure neuroendoscopy intervenes) operation, scope and scope sheath cooperation are inseparable, and the sheath body is closely wrapped up by brain tissue in addition, leads to hematoma chamber and external atmosphere not to communicate with each other. At this time, when water is injected into the hematoma cavity, and operations such as flushing, expanding and the like are carried out, the intracranial pressure is extremely high, and then the brain function is damaged.

The traditional ultrasonic endoscopes such as Fujifilm EG-580UR radial ultrasonic endoscope, Olympus GF-UC140P-AL5 curved linear array (convex array) ultrasonic endoscope, Olympus TGF-UC180J linear ultrasonic endoscope, PENTAX EB-1970UK endobronchial ultrasonic endoscope, Olympus EBUS BF-UC180F bronchoscope and the like have large diameter of the endoscope body, usually tens of millimeters, and are particularly suitable for detection in abdominal cavity. The traditional ultrasonic endoscope 1 is mainly designed for gastrointestinal tracts and respiratory tracts, although the head can be bent to cater to the trend of the human body cavity (the head is bent integrally), the bending angle is too large, and when the ultrasonic endoscope is used in the brain, the too large bending can bring serious cutting to brain tissues. 2. Most of the traditional ultrasonic endoscopes are planar circular scanning/planar linear scanning, the two-dimensional ultrasonic images are not visual enough, and operators have some difficulties in understanding (structure and direction control) of the planar ultrasonic images. 3. Although the head of the traditional ultrasonic endoscopes is smooth and can not damage the inner wall of the cavity when entering the cavity of a human body, the head of the traditional ultrasonic endoscopes is not suitable for the puncture of brain tissues.

Of course, in the operation of removing intracranial hematoma, before the sheath tube and the suction tube are inserted, an ultrasonic device may be used extracranially to perform ultrasonic detection on the lesion site, and after the detection is completed, the sheath tube and the suction tube may be inserted. And then extracranial detection is carried out again by adopting the ultrasonic equipment after the suction is finished. The method comprises the following steps: firstly, most of ultrasonic probes probe the brain structures in a way of clinging to the scalp, the skull or the dura mater, and the accurate positioning and clear images cannot be obtained due to excessive intermediate media. Secondly, most of the ultrasonic equipment in the operation is mainly used for exploring the brain tissue structure at the beginning and the end of the operation; if the real-time detection is needed in the operation, the working instrument needs to be withdrawn, the ultrasonic probe is inserted into the head wound to detect the brain tissue structure, and then the working instrument is put in again, so that the operation time is seriously delayed. Thirdly, another way to achieve intraoperative ultrasound is: opening a special detection window for the ultrasound probe, or further enlarging the current surgical incision, is obviously not conducive to patient recovery.

Disclosure of Invention

In view of the above, the first objective of the present invention is to provide an intracranial hematoma aspiration device for neurosurgery.

The purpose of the invention is realized by the following technical scheme: an intracranial hematoma suction apparatus for neurosurgery, comprising a suction part and an operation part, characterized in that: the suction part comprises a pipe body, the pipe body is provided with a hollow working channel, the front end of the pipe body is provided with an ultrasonic detection assembly, a camera shooting illumination assembly and a pressure detection assembly, the rear end of the pipe body is connected with the operation part, and the operation part is provided with a rotary driving mechanism for driving the suction part to rotate and a rotary driving mechanism for driving the camera shooting illumination assembly to rotate; the operating part is provided with a working channel guide pipe capable of moving axially, the head of the working channel guide pipe is bent towards one side, the working channel guide pipe is made of elastic materials, and the operating part further comprises a translation driving mechanism for driving the working channel guide pipe to move axially along the working channel; auxiliary channel pipes are respectively arranged on the left side and the right side of the working channel in the pipe body.

Furthermore, the ultrasonic detection assembly comprises an ultrasonic probe which is arranged at the head of the pipe body and is positioned on one side of the outlet end of the working channel, the ultrasonic probe is provided with an arc-shaped detection surface facing one side of the outlet of the working channel, the ultrasonic probe also comprises an ultrasonic wire harness connected with the ultrasonic probe, and the ultrasonic wire harness penetrates through a wire harness channel A of the pipe body and extends outwards.

Furthermore, the camera shooting and illuminating assembly comprises a rotating block which is arranged at the head of the tube body and is positioned at the other side of the outlet end of the working channel, and a camera and an illuminating lamp are arranged on the front end face of the rotating block; the rotating block is movably connected with the head of the tube body, and the rotating block can rotate back and forth along the axis direction of the tube body to the direction far away from the arc-shaped detection surface through the rotation driving mechanism.

Further, the pipe body includes anterior body and rear portion body, the operation portion is installed on the rear portion body, the operation portion includes the operation body, the operation body include with the cover establish installation department on the rear portion body and with the portion of gripping that the installation department is connected.

Furthermore, the rotation driving mechanism comprises a steel wire connected with the rotating block, the steel wire penetrates through the front pipe body and is connected with the clamping plate assembly, a sliding groove is formed in the bottom of the clamping plate assembly, a sliding way matched with the sliding groove is formed in the rear pipe body, a pull wire sleeve is sleeved outside the rear pipe body and is located in the installation portion, a first step surface matched with the front end surface of the clamping plate assembly is arranged on the inner end surface of the pull wire sleeve, and a second step surface is arranged on the outer rear portion of the pull wire sleeve; the wire drawing sleeve is positioned in the U-shaped part, the upper end of the U-shaped part is connected with the shaft, and the U-shaped part abuts against a second step surface behind the outer wall of the wire drawing sleeve; the front end of the wire drawing sleeve is provided with a third step surface, the front end of the U-shaped part of the trigger in the mounting part is provided with a fourth step surface, the third step surface, the outer wall of the wire drawing sleeve, the inner wall of the mounting part and the fourth step surface form a first accommodating cavity, and a trigger reset spring is arranged in the first accommodating cavity; the front end of the front pipe body is provided with an open slot, the rotating block is located in the open slot, the left side wall and the right side wall of the rotating block are hinged to the front pipe body through short shafts, a rotating block reset spring is sleeved on the short shafts, one end of the rotating block reset spring abuts against the bottom surface of the rotating block, and the other end of the rotating block reset spring is inserted into the bottom surface of the open slot.

Further, the rotation driving assembly further comprises a rotation locking assembly, the locking assembly comprises a U-shaped friction plate located in the installation portion, the U-shaped friction plate is clamped on the connecting portion between the U-shaped portion and the finger buckling portion of the trigger, an opening end of the U-shaped friction plate is connected with an adjusting screw, and the adjusting screw stretches out of the installation portion and is provided with a locking knob.

Furthermore, the rotary driving mechanism comprises an adjusting block arranged at the rear end of the rear pipe body, the adjusting block is positioned outside the operation body and is provided with a conical outer wall, and an adjusting shifting sheet is arranged on the outer wall of the adjusting block; the rotary driving mechanism further comprises a rotary locking assembly, the rotary locking assembly comprises spline teeth which are arranged on the outer wall of the rear pipe body and located in front of the adjusting block, a wedge block which can be matched with the spline teeth is arranged below the spline teeth, a second accommodating cavity is arranged in the holding portion below the wedge block, a locking spring is arranged in the second accommodating cavity, a protruding block which abuts against the locking spring is arranged on the upper portion of the second accommodating cavity, the protruding block is provided with a protruding portion which extends out of the accommodating cavity upwards, and the top end of the protruding portion abuts against the lower end of the rear portion of the wedge block; the front of the wedge block is rotatably hinged with the operation body through an installation shaft, one end of the installation shaft extends out of the operation body and is connected with the shifting block, a convex block is arranged on the inner end face of the shifting block, and a groove matched with the convex block is formed in the wedge block.

Further, the translation driving mechanism comprises a flat groove arranged at the tail part of the rear pipe body, a slide way is arranged on the flat groove, a fine adjustment sliding block is arranged on the slide way in a sliding manner, external threads are arranged on the outer wall of the fine adjustment sliding block, and the outer end part of the fine adjustment sliding block is fixedly connected with the working channel guide pipe through screws; a fine adjustment rotating cylinder is arranged on the outer wall of the fine adjustment sliding block and the outer wall of the rear pipe body, an internal thread matched with the external thread of the fine adjustment sliding block is arranged on the inner wall of the fine adjustment rotating cylinder, a circumferential raised line is arranged on the pipe wall of the rear pipe body on the side opposite to the flat groove, and a circumferential groove matched with the circumferential raised line is arranged on the inner wall of the fine adjustment rotating cylinder; the outer wall of the fine adjustment rotating cylinder is provided with a rotating friction part.

The suction device further comprises a matched sheath tube, the front part of the tube body is positioned in the sheath tube, the outer diameter of the tube body is smaller than the inner diameter of the sheath tube, and the head part of the sheath tube is provided with a puncturing mechanism.

Preferably, a vesicle membrane is bonded to the inner peripheral wall of the opening end of the head of the sheath tube, a vesicle stem is connected to the center of the vesicle membrane, the vesicle stem penetrates through the working channel and extends out from the inlet end of the working channel, and the vesicle membrane is in a drop shape after being filled with water.

Preferably, a clamping cylinder is sleeved on the outer wall of the rear pipe body at the front end of the operation body, and clamping lugs are symmetrically arranged on the clamping cylinder.

Preferably, a passive optical navigation frame is mounted on the upper part of the operation body.

Has the advantages that:

the hematoma suction device creatively combines the ultrasonic device, the neuroendoscope and the suction working channel together to obtain a new ultrasonic neuroendoscope, and the three can be mutually matched in a hematoma removing operation through special structure arrangement, thereby achieving the following effects:

1. according to the hematoma suction device, the ultrasonic neuroendoscopy uses the ultrasonic probe to detect hematoma, and the condition in a hematoma cavity can be detected by utilizing ultrasonic when the optical imaging quality is poor. Open the ultrasonic detection subassembly, thereby can realize through the rotation drive mechanism of operating portion that pipe body rotation a week reaches ultrasonic probe and rotates 360 around the axial, the completion is to the drawing on hematoma border, remedies the unclear defect of camera formation of image. Helps the operator to know the hematoma condition in the cavity as early as possible, and know the hematoma boundary condition, peripheral blood vessel distribution and the like when the hematoma begins to be sucked.

2. According to the hematoma suction device, the lens (and the light source) of the ultrasonic neuroendoscope can rotate the camera shooting illumination assembly through rotating the driving mechanism so as to observe tissues in the endoscope side direction, meanwhile, working instruments (such as a suction tube and electrocoagulation) can be twisted by virtue of the working channel guide tube with the bending head and the elastic performance in the working channel so as to point to target tissues in the endoscope side direction together, the swinging of the endoscope (tube body) body is not needed in the whole working process, the endoscope only has the back-and-forth (advancing and retreating) movement along the axis and the rotating movement around the axis, and the injury to brain tissues is small.

3. The hematoma suction device provided by the invention has the advantages that the distribution condition of blood vessels around a hematoma cavity is explored by an arc detection surface (Doppler mode) of an ultrasonic probe of the ultrasonic neuroendoscopy, local three-dimensional reconstruction is carried out on the blood vessels, and the blood vessels are displayed on a display observed by an operator, so that the operator can know which piece of hematoma is behind and has important blood vessels, and the hematoma can be removed or retained.

4. According to the hematoma suction device, the head of the tube body is integrated with the intracranial pressure sensor (ICP sensor), and the intracranial pressure condition is fed back in real time in the whole process of puncture and cleaning, so that an operator can know the value of the intracranial pressure at any time, and further the lavage flow and suction quantity are adjusted, and the damage to brain tissues caused by the overhigh intracranial pressure for a long time is prevented.

5. According to the hematoma suction device, only the lens (and the light source) of the ultrasonic neuroendoscope can rotate, the steering of the working instrument is realized by the working channel catheter, the endoscope body (the tube body) has no bending change, and the influence on brain tissues is small during working.

6. The hematoma suction device provided by the invention uses the miniature ultrasonic probe capable of real-time three-dimensional imaging to carry out three-dimensional imaging on a small part of area (current observation area) in a hematoma cavity, reconstructs the tissue structure and the working instrument pose in the range, and simultaneously displays the color Doppler image of the blood vessel around the hematoma cavity on the three-dimensional reconstruction model, thereby helping an operator to better know the brain tissue structure.

7. The hematoma suction device is matched with the ultrasonic neuroendoscopy to use the sheath tube which has a relatively sharp head shape. Is suitable for puncturing brain tissue, and the brain tissue is pushed away gently during puncturing, so that the damage to the brain tissue is reduced to the maximum extent.

8. According to the hematoma suction device, the rotary driving mechanism of the ultrasonic detection assembly, the rotary driving mechanism of the camera shooting illumination assembly and the translation driving mechanism of the working channel catheter in the tube body are integrated on the same operation part, and the rotary driving mechanism are provided with locking functions, so that an operator can conveniently adjust the hematoma suction device in an operation, the hematoma suction device has high adjusting precision and reliability, and the efficiency of the operator can be improved.

Drawings

The drawings of the present invention are described below.

FIG. 1 is an isometric view of an intracranial hematoma aspiration device for neurosurgery (without a sheath assembly) in the embodiment;

FIG. 2 is a left side view of an intracranial hematoma aspiration device (sheath assembly) for neurosurgery in accordance with an embodiment;

FIG. 3 is a top view of a suction portion of an intracranial hematoma suction apparatus for neurosurgery in accordance with an embodiment;

FIG. 4 is a left side view of a suction portion of an intracranial hematoma suction apparatus for neurosurgery in accordance with an embodiment;

FIG. 5 is a cross-sectional view of FIG. 4;

FIG. 6 is an enlarged view of FIG. 5;

FIG. 7 is a view showing the configuration of the head of the tube body of the hematoma aspiration device in the embodiment (including the lens cap);

FIGS. 8-13 are block diagrams of the tube body head and the ultrasound probe assembly, the camera illumination assembly and the pressure probe assembly of the hematoma aspiration device of an embodiment (without the lens cap);

figure 14 is a top view of the tube body of the hematoma aspiration device of an embodiment;

FIG. 15 is a cross-sectional view of FIG. 14 (showing the wire harness and wire channels);

fig. 16 is an isometric view of the internal structure of the operating portion of the hematoma aspiration device in an example (left body without the operating body);

fig. 17 is a left side view (a left body not including the operation body) of the internal structure of the operation portion of the hematoma aspiration device in the embodiment;

fig. 18 is a right side view (right body without operation body) of the internal structure of the operation portion of the hematoma aspiration device in the embodiment;

fig. 19 is an exploded view one of the translation drive mechanism of the operation part of the hematoma aspiration device in the embodiment;

fig. 20 is an exploded view of the translational drive mechanism of the operating portion of the hematoma aspiration device in an embodiment;

fig. 21 is a sectional view (a water-filled state and a non-water-filled state) of the sheath assembly in the embodiment;

FIGS. 22a to 22o are flow charts of the suctioning method performed by the hematoma suctioning device in the example.

Description of reference numerals:

the suction part 100, the operation part 200,

a tube body 1, a working channel 2, a working channel duct 201, an auxiliary channel 3, an auxiliary channel tube 301,

an ultrasonic detection component 4, a camera shooting illumination component 5, a pressure detection component 6,

an ultrasound probe 401, an ultrasound beam 402, an arcuate probe face 403, a beam channel a404,

a turning block 501, a camera 502, an illuminating lamp 503, a wiring harness channel B504, a camera illuminating wiring harness 505, an opening groove 506, a lens cover 507,

a pressure sensor 601, a sensor harness 602, a harness channel C603,

a front tube 101, a rear tube 102, a scale 103,

a rotary driving mechanism 7, a rotary driving mechanism 8, a translational driving mechanism 9,

an operation body 10, a mounting portion 1001, a grip portion 1002,

a steel wire 801, a first sliding chute 802, a first slide way 803, a first plane 804, a clamping plate assembly 806, a pull wire sleeve 805, a first step surface 8051, a second step surface 8052, a third step surface 8053, a fourth step surface 8054, a clamping plate assembly 806, a steel wire channel 807, a trigger 808, a U-shaped part 8081, a finger catching part 8082, a shaft 8083, a convex part 8084, a trigger return spring 809, a short shaft 810, a rotating block return spring 811, a U-shaped friction plate 812, an adjusting screw 813, a locking knob 814,

an adjustment block 701, an adjustment paddle 702, spline teeth 703, a wedge block 704, a second receiving cavity 705, a locking spring 706, a protrusion 707, a mounting shaft 708, a locking paddle 709,

a flat groove 901, a second slideway 902, a fine adjustment slide block 903, an external thread 904, a connecting part 905, a fine adjustment rotating cylinder 906, an internal thread 907, a circumferential convex strip 908, a circumferential groove 909, a rotating friction part 9010,

sheath 11, puncturing part 12, vesicle 1201, water injection pipe 1202, clamping cylinder 13, clamping lug 1301 and passive optical navigation frame 14.

Detailed Description

Reference will now be made in detail to embodiments of the present application, examples of which are illustrated in the accompanying drawings, wherein like or similar reference numerals refer to the same or similar elements or elements having the same or similar function throughout. The embodiments described below with reference to the drawings are exemplary only for the purpose of explaining the present application and are not to be construed as limiting the present application. On the contrary, the embodiments of the application include all changes, modifications and equivalents coming within the spirit and terms of the claims appended hereto.

Example (b): as shown in fig. 1 to 21, the present embodiment provides an intracranial hematoma aspiration device for neurosurgery, which includes an aspiration unit 100 and an operation unit 200.

The suction part comprises a pipe body 1, the pipe body is provided with an axial hollow working channel 2, a working channel guide pipe 201 capable of moving axially is arranged in the working channel, the head of the working channel guide pipe is bent towards one side, and the working channel guide pipe is made of elastic materials, such as super-elastic nickel alloy. Auxiliary channels 3 which are axially communicated are respectively arranged on the left side and the right side of the working channel in the pipe body, and auxiliary channel pipes 301 are arranged in the auxiliary channels. Meanwhile, an axially through wiring harness channel is also arranged in the pipe body.

In the present embodiment, the front end (head) of the tube body is provided with an ultrasonic probe assembly 4, a camera illumination assembly 5, and a pressure detection assembly 6.

The ultrasonic detection assembly comprises an ultrasonic probe 401 and an ultrasonic wire harness 402, wherein the ultrasonic probe is arranged at the front end part of the pipe body and is positioned at the lower end of the working channel, and the ultrasonic probe extends forwards from the head end surface of the pipe body along the axial direction. The ultrasonic probe is provided with an arc-shaped detection surface 403 facing one side of the outlet of the working channel, and the back surface of the arc-shaped detection surface is formed by forward extending of the peripheral wall of the pipe body. The ultrasonic beam passes through a beam passage A404 of the pipe body and extends out of the tail end of the pipe body.

The illumination assembly 5 of making a video recording is including making a video recording illumination function portion and the illumination pencil 505 of making a video recording, the illumination function portion of making a video recording sets up equally the front end of pipe body the front end upper portion of pipe body is provided with open slot 506, the illumination function portion of making a video recording is rotationally installed in the open slot, just the illumination pencil of making a video recording by the pencil passageway B504 of pipe body stretches out to the tail end outside of pipe body. Specifically, the method comprises the following steps: the camera shooting and lighting function part comprises a rotating block 501 arranged in the opening groove, and the front end face of the rotating block is provided with a camera 502 and a lighting lamp 503; the turning block with the both sides wall activity hinge joint of open slot, just the turning block can be followed pipe body axis direction is to keeping away from the direction reciprocating rotation of arc detection face, the rotatable angle of the turning block that sets up in this embodiment reaches 90. A lens cover 507 for protecting the lens and the illuminating lamp is arranged at the opening groove.

The pressure detection assembly includes a pressure sensor 601 and a sensor harness 602, and in the present embodiment, the pressure sensor is an ICP sensor. A detection window is arranged on the back of the ultrasonic probe (the surface opposite to the detection surface), the ICP sensor is arranged in the detection window and can detect intracranial pressure from the detection window, and the sensor wire harness extends out of the tail end of the tube body from the tube body wire harness channel C603.

In this embodiment, the tube body is composed of two sections, including a front tube 101 for intracranial aspiration and a rear tube 102 for mounting the operation portion for operation of the operator. Moreover, the outer wall of the front tube body in this embodiment is further provided with scales 103 to read the depth of the probe into the cranium in real time.

The front pipe body is provided with the wiring harness channel A, the wiring harness channel B and the wiring harness channel C. However, only the wiring harness passage a and the wiring harness passage C are provided in the rear pipe body, and the camera illumination wiring harness is merged into the wiring harness passage a and extends out of the tail portion of the rear pipe body together with the wiring harness passage a.

The operation part 200 comprises a rotary driving mechanism 7 for driving the suction part to rotate, a rotary driving mechanism 8 for driving the camera shooting and illuminating assembly to rotate, and a translation driving mechanism 9 for driving the working channel conduit to move axially along the working channel.

Specifically, the method comprises the following steps: the operation portion comprises an operation body 10 used for installing all driving mechanisms, the operation body comprises an installation portion 1001 arranged on the rear pipe body and a holding portion 1002 connected with the installation portion, and the installation portion and the holding portion are L-shaped and integrally arranged. The mounting part and the holding part are a left body and a right body, and the mounting surface of the left body and the mounting surface of the right body are spliced and locked with each other to form an integrated operation body.

Wherein, rotation actuating mechanism 8 include with the steel wire 801 that lighting components's the turning block of making a video recording is connected, the steel wire can be one or many, in this embodiment the steel wire is two about. The wire passes through a wire passage 807 in the front tube and connects with a cleat assembly 806 at the rear tube.

The bottom of the clamping plate component is provided with a first sliding groove 802, and a first sliding way 803 matched with the first sliding groove is arranged on the rear pipe body. In this embodiment, a recessed first plane 804 is disposed at the rear pipe body, the first slide is disposed on the first plane, the clamping plate assembly includes a lower clamping plate and an upper clamping plate, the first slide groove is disposed on the bottom surface of the lower clamping plate, the upper clamping plate and the lower clamping plate are locked by screws, a U-shaped rotating portion is disposed at the tail end of each steel wire, and the U-shaped rotating portion is sleeved on the screws and locked by the upper clamping plate and the lower clamping plate.

A wire drawing sleeve 805 is sleeved outside the rear pipe body and located in the installation portion, and a first step surface 8051 matched with the front end surface of the clamping plate assembly is arranged on the inner end surface of the wire drawing sleeve. A second step surface 8052 is arranged at the outer rear part of the wire pulling sleeve; . Still include trigger 808, trigger upper portion is for being located installation department inscribe and upper portion open-ended U type portion 8081, the trigger lower part is for being located outside the operation body and being located detain finger portion 8082 before the portion of gripping. The wire drawing sleeve is located in the U-shaped portion, the upper end of the U-shaped portion is connected through a shaft 8083, the U-shaped portion is provided with a protruding portion 8084 protruding backwards, and the protruding portion abuts against a second step surface on the rear portion of the outer wall of the wire drawing sleeve. The front end of wire drawing sleeve outer wall is provided with third step 8053, the installation department inner wall is located the front end of the U type portion of trigger is provided with fourth step 8054, third step, wire drawing sleeve outer wall, installation department inner wall and the fourth step forms the first chamber that holds, the first intracavity that holds is provided with trigger reset spring 809. As another implementation manner in this embodiment, a front end surface of the wire pulling sleeve and a front end surface of the first plane of the rear pipe body are in inclined plane fit.

In this embodiment, the left and right side walls of the rotating block are hinged to the left and right side walls of the open slot, that is, the front tube body, through a short shaft 810, a rotating block return spring 811 is sleeved on the short shaft, one end of the rotating block return spring abuts against the bottom surface of the rotating block, and the other end of the rotating block return spring is inserted into the bottom surface of the open slot.

By adopting the above-mentioned rotation driving mechanism in this embodiment, the operator can push the pull-wire sleeve backwards by pulling the finger-fastening portion on the trigger, the pull-wire sleeve further pulls the clamping plate assembly to drive the steel wire to slide backwards, and the steel wire slides backwards to further realize that the turning block overcomes the torsion of the turning block return spring 811, and the turning block rotates around the short shaft 810, and finally, the lighting lamp and the camera realize rotation.

As another implementation manner in this embodiment, the rotation driving assembly further includes a rotation locking assembly, the rotation locking assembly includes a U-shaped friction plate 812 located in the installation portion, the U-shaped friction plate clamps the connection portion between the U-shaped portion and the finger fastening portion of the trigger, an opening end of the U-shaped friction plate is connected with an adjusting screw 813, and the adjusting screw extends out of the installation portion and is fixed with the locking knob 814. In this embodiment, the locking knob and the adjusting screw are integrally disposed, but may be fixed by other methods such as welding.

Wherein, rotary driving mechanism 7 is including setting up the regulating block 701 of the rear end of rear portion body, the regulating block is located outside the operation body, the regulating block has the toper outer wall, be provided with on the toper outer wall of regulating block and adjust plectrum 702. The adjusting block and the rear pipe body can be arranged in a split mode or in an integrated mode. In this embodiment, the regulating block with rear portion body sets up as an organic whole. And the big end face of the adjusting block faces the operation body and is attached to the end face of the operation body.

As another implementation manner in this embodiment, the rotation driving mechanism further includes a rotation locking assembly, the rotation locking assembly includes a spline tooth 703 that is disposed on an outer wall of the rear pipe body and is located in front of the adjusting block, the spline tooth may be integrally disposed with the rear pipe body or may be separately disposed, and in this embodiment, the spline tooth is integrally disposed on the rear pipe body. A wedge block 704 which can be matched with the spline teeth is arranged below the spline teeth, and the wedge block is provided with an insertion part which can be inserted into the spline teeth. A second accommodating cavity 705 is formed in the holding part below the wedge-shaped block, a locking spring 706 is arranged in the second accommodating cavity, a protruding block 707 which abuts against the locking spring is arranged at the upper part of the second accommodating cavity, the protruding block is provided with a protruding part which extends out of the accommodating cavity upwards, and the top end of the protruding part abuts against the lower end of the rear part of the wedge-shaped block; the front part of the wedge block is rotatably hinged with the operation body through an installation shaft 708, one end of the installation shaft extends out of the operation body and is connected with a locking shifting block 709, a convex block is arranged on the inner end face of the shifting block, and a groove matched with the convex block is formed in the wedge block.

The operator can realize the autorotation of the whole tube body and the attached components such as an ultrasonic detection component, a camera shooting illumination component, a pressure detection component, a suction component and the like along the axis of the tube body by rotating the adjusting shifting sheet on the adjusting block. And the position locking after the rotation can be realized by rotating the locking shifting block.

The translation driving mechanism 9 is disposed in a flat groove 901 at the tail of the rear pipe body, the flat groove penetrates through the rear pipe body backwards, an axial second slide 902 is disposed on the flat groove, a fine adjustment slider 903 is slidably disposed on the second slide, and an external thread 904 is disposed on an outer wall of the fine adjustment slider. The tail end of the working channel conduit is provided with a connecting part 905 protruding upwards after extending out of the working channel, the connecting part is fixedly connected with the outer end face of the fine adjustment sliding block, and the connecting part is connected with the outer end face of the fine adjustment sliding block through a screw. A fine adjustment rotating cylinder 906 is arranged on the outer wall of the fine adjustment sliding block and the outer wall of the rear pipe body, an internal thread 907 matched with an external thread of the fine adjustment sliding block is arranged on the inner wall of the fine adjustment rotating cylinder, a circumferential protruding strip 908 is arranged on the pipe wall of the rear pipe body on the side opposite to the flat groove, and a circumferential groove 909 matched with the circumferential protruding strip is arranged on the inner wall of the fine adjustment rotating cylinder; and the outer wall of the fine tuning rotating cylinder is provided with a rotating friction part 9010.

The operator rotates through holding the rotating friction part the fine adjustment rotating cylinder, the axial movement can be realized through the principle of the lead screw nut under the rotation of the fine adjustment sliding block and the fine adjustment rotating cylinder, and because the fine adjustment rotating cylinder is axially fixed with the rear pipe body, the fine adjustment sliding block can slide along the axial direction of the rear pipe body, and then the working channel guide pipe axially moves in a driving mode.

In this embodiment, the front end of the working channel conduit is curved, and the working channel is made of elastic material, such as super-elastic nickel alloy material. When the working channel catheter is fully positioned in the working channel, functional components such as a suction tube and the like can be extended into the cranium along a linear direction (axis) to suck hematoma positioned right in front. When the working channel catheter extends out of the working channel, the working channel catheter loses the limitation of the working channel and can be in a bending state, different bending angles can be presented according to different extending lengths, and hematoma on the side of the working channel can be sucked at the moment.

As another implementation manner in this embodiment, the hematoma aspiration device in this embodiment may further include a sheath assembly, which is a disposable medical article.

In the present embodiment, the sheath assembly includes a sheath 11 and a puncturing part 12 at a front end of the sheath. The forward tube body may be located within the sheath and the tube body has an outer diameter less than an inner diameter of the sheath so that the tube body is axially movable within the sheath. And the sheath tube can be also provided with scale marks.

As an implementation manner in this embodiment, the piercing mechanism includes a water drop-shaped plastic water bag 1201, a water injection pipe 1202 communicated with the tail of the plastic water bag is provided at the end of the water injection pipe connected to the plastic water bag, a water outlet is provided at the end of the water injection pipe connected to the plastic water bag, the water injection pipe penetrates into the working channel and extends out from the tail end of the working channel, the plastic water bag is located at one side of the head of the pipe body, and the head of the plastic water bag extends out of the sheath pipe and is conical after being filled with water.

As one of the embodiments in this embodiment, a clamping cylinder 13 is sleeved on an outer wall of the front end of the operation body, and clamping protrusions 1301 are symmetrically arranged on the clamping cylinder. . By adopting the design, the clamping of the surgical robot (mechanical arm) can be facilitated. If the suction device has been adjusted to an optimum angle, it can be gripped by a robot to ensure stability.

As another implementation manner in this embodiment, a passive optical navigation frame 14 is installed on the upper portion of the operation body.

In addition, the present embodiment also provides a suction method using the hematoma suction apparatus for neurosurgery of the present embodiment, including the following steps (see fig. 22a to 22 o):

preoperative preparation work:

STEP 1.1: patient admission, CT or MRI, and three-dimensional brain reconstruction. The shape, size and location information of the hematoma in the cranium are obtained.

STEP 1.2: and taking the geometrical central point A of the hematoma, and planning a puncture path. The shortest route which can avoid important brain tissue structures and blood vessels is selected, the long axis direction of hematoma is selected as much as possible, and the intervention points B and ((planning) intervention depth L are determined (planning) intervention direction from B to A.

Extracranial operation in operation:

STEP 2.1: the patient is brought into the operating room. The determination of the (actual) intervention direction and the (actual) intervention point is carried out with reference to the intervention point, the intervention direction and the intervention depth planned in STP 1.2. As is well known in the art, the following may be selected: body surface mark point positioning method, framed stereotactic puncture, frameless navigation puncture (including but not limited to active optical navigation, passive optical navigation, electromagnetic navigation, automatic puncture of surgical robot, etc.), etc. The resulting (actual) intervention point B' and the (actual) intervention direction are determined by the method described above. And then a small bone window is opened at point B' (dura mater not exposed).

STEP 2.2: considering the problems of brain displacement, hematoma enlargement and the like which may occur to a patient in the period from the CT/MRI examination to the bone window opening in an operating room, the final direction verification is also carried out for the subsequent puncture: the well-known small bone window ultrasonic probe (burr-hole) is used to extend into the bone window, the head of the probe is tightly attached to the dura mater, and the probe is continuously adjusted to point to carry out ultrasonic examination on brain tissues. And acquiring an ultrasonic image of brain tissue, and verifying and correcting the intervention direction and the intervention depth after image processing. The corrected (final) intervention end point is a ', (final) intervention depth is L', and B 'to a' are the (final) intervention directions.

Performing intracranial operation in an operation:

STEP 3.1: the dura mater is opened and the hematoma aspiration device (and associated sheath assembly) of this embodiment is inserted into the hematoma chamber according to the (final) direction of intervention determined in STEP2.1 and STEP 2.2. Here, the explanation is made by taking the penetrating portion as a vesicle membrane. Before puncture, water is injected into the vesicle membrane in the sheath tube to keep the vesicle membrane full, so that the sheath tube can penetrate into the deep part of the brain tissue conveniently to reduce the damage to the brain tissue. And in the puncture process, the front tissue condition is constantly detected through the ultrasonic detector and the endoscope camera, if the blood vessel blockage is found on the puncture path, the pointing direction of the sheath tube is slightly adjusted, and the sheath tube continuously penetrates after the blood vessel is avoided.

STEP 3.2: during the puncture process, the scale marks outside the sheath tube are observed, and the intervention depth is observed. When the intervention depth reached the (final) intervention depth L of 4, the puncture was stopped and the sheath was fixed. The sheath head reaches the intervention end point a' in 4.

STEP 3.3: stopping filling water into the vesicle, and simultaneously pulling the vesicle stem to gradually tear off the vesicle membrane tightly attached to the inner wall of the sheath tube. The vesicle is entirely withdrawn (from the working channel), the working channel is vacant, and a small part of hematoma will flow out through the working channel by itself under the action of intracranial pressure. The guide tube and the suction tube are installed (the suction tube is nested in the guide tube).

STEP 3.4: keeping the sheath pipe still, extending the head of the ultrasonic neuroendoscope (pipe body) out of the sheath pipe. At the moment, a large amount of loose hematoma exists in the hematoma cavity, but the hematoma cannot be discharged automatically, the visibility of the endoscope camera in the visual field is poor, and the boundary of the hematoma cavity can be detected through the ultrasonic detector. Through axial rotation and push-and-pull endoscope body (tube body), the ultrasonic image obtained by the ultrasonic detector is subjected to three-dimensional reconstruction, and the shape and boundary information of the hematoma cavity can be obtained.

STEP 3.5: the head of the working channel conduit extends out of the working channel and naturally bends by adjusting a fine adjustment knob of the translation driving mechanism. The suction tube is extended slightly out of the working channel duct, the suction device is opened and the suction tube mouth immediately generates negative pressure. At this time, the hematoma close to the lens is sucked into the suction tube opening and then is sucked out of the body.

Inject into liquid in the pipe from two auxiliary passage, the clear liquid of injection can form a clear (water) chamber relatively around the scope camera lens, and scope camera lens all contains in this intracavity with the suction tube, and scope camera lens visibility becomes good, can see the front end of suction tube, realizes the visual clear away of hematoma promptly. Wherein the clear liquid may be: warm saline, warm artificial cerebrospinal fluid, ultrasound coupling fluid (warm) for improving the quality of ultrasound images, etc.

Through axial push-and-pull, rotatory scope mirror body (proper withdrawal endoscope sheath when necessary), can control the scope camera lens and shoot any position in hematoma chamber, and then realize that the scope is to the visual clearance of most hematoma in the hematoma chamber.

In the process, the ultrasonic detector detects the boundary of the hematoma cavity at any time, and prevents the endoscope lens from moving to touch excessively and even hurting brain tissues at the boundary of the hematoma cavity. Meanwhile, the ultrasonic detector can also be used for guiding an operator to reduce the suction intensity when the suction pipe orifice is close to the boundary of the hematoma cavity, so that the injury to normal brain tissue outside the hematoma cavity due to excessive suction is avoided.

Meanwhile, the ultrasonic detector can be used for detecting whether blood vessels exist in the hematoma cavity and distribution of the blood vessels, and an operator can plan a next operation conveniently.

In the moving, flushing and sucking processes, the change condition of the intracranial pressure is detected by the ICP sensor on the lens at any time so as to prevent the intracranial pressure from being overhigh due to over-perfusion.

STEP 3.6: through continuous washing and suction, most loose hematomas in the hematoma cavity are sucked out of the body by the suction tube, clear water solution is mainly left in the cavity, and the visibility is remarkably improved. A small amount of hematoma remains on the wall of the hematoma chamber. The two auxiliary channels keep liquid inlet, continue to extend the suction tube, axially push-pull and rotate the endoscope (withdraw the sheath tube if necessary), and accurately suck the residual hematoma one by one under the observation of the endoscope camera.

STEP 3.7: when cleaning a single hematoma, the Doppler mode of the ultrasonic detector is used for detecting the distribution of peripheral blood vessels at any time, if important blood vessels flow behind a hematoma block to be cleaned, and if forced cleaning possibly causes new active bleeding, the hematoma block is carefully cleaned, or the cleaning is abandoned.

STEP 3.8: if the hematoma piece is too big, too hard, be difficult to through the suction tube outside the body of drawing, then adjust suction to the minimum, adsorb this piece of hematoma, keep the sheath pipe motionless, with the neural scope of supersound together pull out with the adsorbed bold hematoma of its head in vitro, wash the adsorbed hematoma piece of internal lens portion after, insert the scope back in the sheath, continue follow-up clearance.

STEP 3.9: if the ultrasound transducer finds that a part of hematoma is wrapped due to the reoccurrence of the brain tissue in the cleaning process, a proper amount of water is injected into the cavity to stretch the hematoma cavity under the detection of the ICP sensor, so that the wrapped hematoma is exposed and then cleaned.

STEP 3.10: in the pumping process, water is constantly fed into the two auxiliary working channels, and the suction pipe in the guide pipe drains water.

The constant flushing of the hematoma cavity can improve the visibility in the cavity and facilitate the operation of the neuroendoscopy; meanwhile, the matters such as the brain tissue fragments and hematoma fragments which are dissociated in the cavity can be discharged in time, so that the secondary injury caused by the matters to the brain tissue is reduced; in addition, through continuous flushing, active bleeding points can be found in time.

The active bleeding point is characterized in that free blood filaments are continuously observed under an endoscope camera.

At the moment, the suction tube is withdrawn, the two auxiliary working channels are changed into water inlet and water discharge, the electrocoagulation is inserted into the working channel (in the guide tube), the electrocoagulation head extends out of the endoscope, and then the electrocoagulation is moved to a bleeding point (by axially pushing and pulling and rotating the endoscope body) under the monitoring of the endoscope camera, so that accurate electrocoagulation hemostasis is realized.

STEP 3.11: and (3) withdrawing the ultrasonic neuroendoscope and the sheath tube after no residual hematoma exists in the hematoma cavity (blood vessels flow behind the back and the hematoma blocks which can induce new active hemorrhage are removed by forced cleaning) and no active hemorrhage exists in the hematoma cavity.

The ICP sensor on the ultrasonic neuroendoscope used in the operation is detached (drawn out from the tail end of the endoscope body and taken down) and then is inserted into the hematoma cavity again, and the outer end of the ICP sensor is fixed on the scalp of the patient. The operation wound is closed. The patient is sent out of the operating room.

Finally, the above examples are intended only to illustrate the technical solution of the present invention and not to limit it, and although the present invention has been described in detail with reference to preferred embodiments, it will be understood by those skilled in the art that various changes in form and detail may be made therein without departing from the scope of the invention defined by the appended claims.

Claims (10)

1. An intracranial hematoma suction apparatus for neurosurgery, comprising a suction part and an operation part, characterized in that: the suction part comprises a pipe body, the pipe body is provided with a hollow working channel, the front end of the pipe body is provided with an ultrasonic detection assembly, a camera shooting illumination assembly and a pressure detection assembly, the rear end of the pipe body is connected with the operation part, and the operation part is provided with a rotary driving mechanism for driving the suction part to rotate and a rotary driving mechanism for driving the camera shooting illumination assembly to rotate; the operating part is provided with a working channel guide pipe capable of moving axially, the head of the working channel guide pipe is bent towards one side, the working channel guide pipe is made of elastic materials, and the operating part further comprises a translation driving mechanism for driving the working channel guide pipe to move axially along the working channel; auxiliary channel pipes are respectively arranged on the left side and the right side of the working channel in the pipe body.

2. The intracranial hematoma aspiration device for neurosurgery according to claim 1, wherein: the ultrasonic detection assembly comprises an ultrasonic probe which is arranged at the head of the pipe body and is positioned on one side of the outlet end of the working channel, the ultrasonic probe is provided with an arc detection surface facing one side of the outlet end of the working channel, the ultrasonic detection assembly further comprises an ultrasonic wire harness connected with the ultrasonic probe, and the ultrasonic wire harness penetrates through a wire harness channel A of the pipe body and extends outwards.

3. An intracranial hematoma aspiration device as recited in claim 2, wherein: the camera shooting and illuminating assembly comprises a rotating block which is arranged at the head of the tube body and is positioned at the other side of the outlet end of the working channel, and a camera and an illuminating lamp are arranged on the front end face of the rotating block; the rotating block is movably connected with the head of the tube body, and the rotating block can rotate back and forth along the axis direction of the tube body to the direction far away from the arc-shaped detection surface through the rotation driving mechanism.

4. An intracranial hematoma aspiration device as recited in claim 3, wherein: the pipe body includes anterior body and rear portion body, the operation portion is installed on the rear portion body, the operation portion includes the operation body, the operation body include with the cover establish installation department on the rear portion body and with the portion of gripping that the installation department is connected.

5. An intracranial hematoma aspiration device as recited in claim 4, wherein: the rotary driving mechanism comprises a steel wire connected with the rotary block, the steel wire penetrates through the front pipe body and is connected with the clamping plate assembly, a sliding groove is formed in the bottom of the clamping plate assembly, a sliding way matched with the sliding groove is formed in the rear pipe body, a pull-wire sleeve is sleeved outside the rear pipe body and is located in the installation portion, a first step surface matched with the front end surface of the clamping plate assembly is arranged on the inner end surface of the pull-wire sleeve, and a second step surface is arranged at the rear part outside the pull-wire sleeve; the wire drawing sleeve is positioned in the U-shaped part, the upper end of the U-shaped part is connected with the shaft, and the U-shaped part abuts against a second step surface behind the outer wall of the wire drawing sleeve; the front end of the pull wire sleeve is provided with a third step surface, the front end of the U-shaped part of the trigger in the mounting part is provided with a fourth step surface, the third step surface, the outer wall of the pull wire sleeve, the inner wall of the mounting part and the fourth step surface form a first accommodating cavity, and a trigger reset spring is arranged in the first accommodating cavity;

the front end of the front pipe body is provided with an open slot, the rotating block is located in the open slot, the left side wall and the right side wall of the rotating block are hinged to the front pipe body through short shafts, a rotating block reset spring is sleeved on the short shafts, one end of the rotating block reset spring abuts against the bottom surface of the rotating block, and the other end of the rotating block reset spring is inserted into the bottom surface of the open slot.

6. An intracranial hematoma aspiration device for neurosurgery as recited in claim 5, wherein: the rotation driving assembly further comprises a rotation locking assembly, the locking assembly comprises a U-shaped friction plate located in the installation portion, the U-shaped friction plate is clamped on the connecting portion between the U-shaped portion and the buckling portion of the trigger, the open end of the U-shaped friction plate is connected with an adjusting screw, and the adjusting screw stretches out the installation portion and the stretching portion are provided with a locking knob.

7. An intracranial hematoma aspiration device as recited in claim 4, wherein: the rotary driving mechanism comprises an adjusting block arranged at the rear end of the rear pipe body, the adjusting block is positioned outside the operation body and is provided with a conical outer wall, and an adjusting shifting sheet is arranged on the outer wall of the adjusting block;

the rotary driving mechanism further comprises a rotary locking assembly, the rotary locking assembly comprises spline teeth which are arranged on the outer wall of the rear pipe body and located in front of the adjusting block, a wedge block which can be matched with the spline teeth is arranged below the spline teeth, a second accommodating cavity is arranged in the holding portion below the wedge block, a locking spring is arranged in the second accommodating cavity, a protruding block which abuts against the locking spring is arranged on the upper portion of the second accommodating cavity, the protruding block is provided with a protruding portion which extends out of the accommodating cavity upwards, and the top end of the protruding portion abuts against the lower end of the rear portion of the wedge block; the front of the wedge block is rotatably hinged with the operation body through an installation shaft, one end of the installation shaft extends out of the operation body and is connected with the shifting block, a convex block is arranged on the inner end face of the shifting block, and a groove matched with the convex block is formed in the wedge block.

8. An intracranial hematoma aspiration device as recited in claim 4, wherein: the translation driving mechanism comprises a flat groove arranged at the tail part of the rear pipe body, a slide way is arranged on the flat groove, a fine adjustment sliding block is arranged on the slide way in a sliding manner, external threads are arranged on the outer wall of the fine adjustment sliding block, and the outer end part of the fine adjustment sliding block is fixedly connected with the working channel guide pipe; a fine adjustment rotating cylinder is arranged on the outer wall of the fine adjustment sliding block and the outer wall of the rear pipe body, an internal thread matched with the external thread of the fine adjustment sliding block is arranged on the inner wall of the fine adjustment rotating cylinder, a circumferential raised line is arranged on the pipe wall of the rear pipe body on the side opposite to the flat groove, and a circumferential groove matched with the circumferential raised line is arranged on the inner wall of the fine adjustment rotating cylinder; the outer wall of the fine adjustment rotating cylinder is provided with a rotating friction part.

9. A neurosurgical intracranial hematoma aspiration device as claimed in any preceding claim, wherein: still include the sheath pipe subassembly, the sheath pipe subassembly includes the sheath pipe and is located the portion of piercing of sheath pipe front end, the sheath intraductal diameter is greater than the external diameter of anterior body.

10. An intracranial hematoma aspiration device for neurosurgery according to any preceding claim, wherein: the outer wall of the rear pipe body positioned at the front end of the operation body is provided with a clamping cylinder, and clamping lugs are symmetrically arranged on the clamping cylinder; and/or a passive optical navigation frame is arranged on the upper part of the operation body.

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