CN207412209U - Medical handle and trepan system - Google Patents

Abstract

The utility model provides a kind of medical handle and trepan system, wherein medical handle includes holding handle, with holding the handle sheath being fixedly connected and the ring that can be sleeved on the relative rotation in sheath, wherein, clamping piece is provided in sheath, clamping piece is under the action of ring, shift in position can be realized between operating position and retraction position, retraction position is than operating position on the radial further from the pivot of ring.By rotating ring, clamping piece is under the action of ring, shift in position can be realized between operating position and retraction position, while medical trepan can be effectively prevented occurring de- sheath during the work time, medical trepan is removably fixedly connected with handle, to reduce replacement cost, work efficiency is improved.

Description

Medical handle and trepan system

Technical field

The utility model is related to medical instruments fields, specifically, are related to a kind of medical handle and trepan system.

Background technology

In clinical operation, it usually needs shaped using trepan for lumbar intervertebral foramen is helped to expand.For example, it dashes forward in lumber ertebral disc Go out in the operations such as disease, lumbar spinal stenosis, in order to smoothly appear canalis spinalis, and not to spinal cord, horse hair and nerve root and its blood vessel It causes to damage, the window that opens seam of drilling on lumbar vertebrae vertebral plate by trepan is a kind of safe and simple method.Lumbar intervertebral foramen forming technique Lumbar intervertebral foramen can effectively be expanded, make scope that can enter intraspinal tube with intervertebral spinal fusion, to merging Lateral Recess of Lumbar or intervertebral foramen Narrow person can also be handled together, applicable to each segment protrasion of the lumbar intervertebral disci, greatly expand transforaminal approach through intracutaneous The indication of mirror lumbar discectomy enucleation improves curative effect and security.

Lumbar intervertebral foramen plasty method is various, can have different classifications by following element：1st, forming tool：Trepan, bone file, mill Bore etc.；2nd, whether forming tool is with protection sleeve pipe：Work, guide rod operate outside in protection sleeve pipe；3rd, monitoring means are shaped：X-ray is saturating Depending on the monitoring of, scope；4th, shaping：Upper joint tip, processus articular superior basal part.Permutation and combination is carried out according to above-mentioned element, it can There are many forming techniques, the use of relatively broad lumbar intervertebral foramen forming technique are at present that Hoogland and Schubert is proposed Tessys（transforaminal endoscopic surgical system, Tessys）Technology.Tessys technologies use Outside guide rod step by step trepan, processus articular superior tip is carried out to cut off step by step under X-ray examination, expands intervertebral foramen, scope is sent into vertebra In pipe, first the protrusion of intraspinal tube is extractd, then carries out cleaning in interverbebral disc, be a kind of interverbebral disc it is outer-disk in （outside-inside）Surgical technic.Tessys technologies greatly improve the treatment of transforaminal approach Percutaneous endoscopic menisectomy It imitates, extend operative indication, but its security still has the improved necessity of continuation：1st, shaping is in processus articular superior point Portion, narrow space shape limited extent, and front is the neuromere of exiting nerve root, and inside is dural sac, in forming process, It is sharp without the work cutting edge end of the trepan of protection, neuromere is caused to stimulate and is even damaged.2nd, in the capsular ligament of upper joint tip There is plica synovialis, include abundant nerve endings, the excision of upper joint tip can cause plica synovialis to damage, cause traumatic little Guan Syndrome is saved, it is postoperative to be likely to occur apparent pain in the back.3rd, processus articular superior tip shapes, away from bone lateral crypt position, to combined side The narrow protrasion of the lumbar intervertebral disci of crypts can not be handled effectively, and postoperative curative effect may be caused bad.

Existing trepan is usually two kinds of structure types, the first is to fix trepan using handle, and handle, which has, holds handle And the sheath being fixedly connected with holding handle, trepan is fixed in sheath by way of axially pressing, in surgical procedure In the problem of being susceptible to the de- sheath when exerting oneself excessive, it is necessary to carry out that sheath descend to position again, when causing to perform the operation after de- sheath is generated Between extend or even the mood of doctor can be had an impact, so as to there is the risk for influencing operation；Second for will hold handle and Trepan is made of one formula structure, but when nose wear occurs in trepan, holding handle need to replace together with trepan, improve more Change this into.

The content of the invention

First purpose of the utility model is to provide one kind and can effectively prevent the medical de- sheath of trepan appearance, and detachable therewith The medical handle that ground is fixedly connected.

Second purpose of the utility model is to provide more than one and states medical handle structure, and medical safe height and work Make efficient trepan system.

In order to realize first purpose of the utility model, medical handle provided by the utility model include holding handle, with The handle sheath being fixedly connected and the ring that can be sleeved on the relative rotation in sheath are held, wherein, clamping is provided in sheath Part, clamping piece can realize shift in position under the action of ring between operating position and retraction position, and retraction position compares work Position is on the radial further from the pivot of ring.

By above scheme as it can be seen that by rotating ring, clamping piece, can be in operating position and retraction position under the action of ring Shift in position is realized between putting.When clamping piece is located at retraction position, chucking power will not be generated to the medical trepan of sheath inner cavity, Medical trepan can be disassembled from handle.When clamping piece is located at operating position, clamping piece is to being located at the doctor of sheath inner cavity Chucking power is generated with trepan, so as to be axially clamped securely to trepan.Further, since it is detachable, when the working end of trepan When wearing, trepan is replaced, reduces replacement cost.

Further scheme is that the inner wall of ring is equipped with arc groove, when clamping piece is located at operating position, ring Inner wall is aligned with clamping piece, and when clamping piece is located at retraction position, arc groove is aligned with clamping piece.

By above scheme as it can be seen that the inner wall of ring be equipped with arc groove, when clamping piece is located at operating position, ring it is interior Wall is aligned with clamping piece, and when clamping piece is located at retraction position, arc groove is aligned with clamping piece.It is simple in structure, clamping can be controlled Part stablizes mobile working, improves the working performance of product.

Further scheme is that the outer wall of sheath is equipped with limiting slot, and clamping position portion and release are equipped in limiting slot Positioning region, ring are equipped with hoodle screw, and the hoodle end of hoodle screw is located in limiting slot, and clamping piece is located at operating position When, hoodle end coordinates with clamping position portion, when clamping piece is located at retraction position, hoodle end and the cooperation of release positioning region.

By above scheme as it can be seen that being equipped with clamping position portion and release positioning region in limiting slot, ring is equipped with hoodle screw, The hoodle end of hoodle screw is located in limiting slot, and when clamping piece is located at operating position, hoodle end coordinates with clamping position portion, When clamping piece is located at retraction position, hoodle end and the cooperation of release positioning region.Ring and the fit precision of sheath are improved, and is carried The high operating accuracy of ring.

Further scheme is that ring is equipped with guide screw, is additionally provided with guide groove on the outer wall of sheath, guide groove with Limiting slot is positioned opposite with the axle center of sheath, and the end of guide screw is located in guide groove.

By above scheme as it can be seen that the end of guide screw is located in guide groove, during ring is rotated, guide groove rises Guiding role, the operation is stable for making ring are accurate.

Further scheme is that sheath is equipped with the locating bar for stretching into sheath inner cavity.

By above scheme as it can be seen that locating bar can stretch into the inner cavity of sheath, so as to which locating bar stretches into one end of the inner cavity of sheath It can coordinate with trepan, realize and the displacement in trepan circumferential direction is defined, respective outer side edges are precisely reliable.

Further scheme is that loop coil is cased in sheath, and loop coil is connected through a screw thread with sheath.

By above scheme as it can be seen that loop coil is sleeved on the shaft shoulder and is threadedly coupled, simple in structure, strong locking ability.

In order to realize second purpose of the utility model, the utility model provides a kind of trepan system, and trepan system includes Step by step widened working sheath, widened expander, step by step widened trepan and working sheath handle, working sheath handle are used for step by step Fixed working sheath, wherein, trepan system further includes to fix the medical handle of trepan, medical handle include holding handle, with The handle sheath being fixedly connected and the ring that can be sleeved on the relative rotation in sheath are held, wherein, clamping is provided in sheath Part, clamping piece can realize shift in position under the action of ring between operating position and retraction position, and retraction position compares work Position is on the radial further from the pivot of ring.

It, can basis by above scheme as it can be seen that the size of the working sheath of trepan system, expander and trepan can expand step by step The demand of operation replace the working sheath, expander and trepan of different packet sizes, improves procedure efficiency, solves Lateral Recess of Lumbar The problem that narrow zone effectively fully depressurizes.The working sheath handle of fixed working sheath is provided on working sheath, is also provided on trepan There is a medical handle of fixed trepan, improve operation safety, make operation faster, conveniently, improve procedure efficiency.

Further scheme is that the working end of working sheath is duckbill, and the end of working end is arcwall face.

By above scheme as it can be seen that the working end of working sheath is duckbill, the end of working end is arcwall face, and arcwall face is effective Prevention work sheath in ground improves operation safety to the iatrogenic injury of peripheral nerve tissue.

Further scheme is that the working end of trepan is provided with multiple blade parts, and blade part is uniform along the circumferential direction of trepan Arrangement, blade part include blade and knife spine, and blade is connected with knife spine, and the axis of blade and trepan is arranged in parallel, and knife spine is arc Face.

It by above scheme as it can be seen that the axis of blade and trepan is arranged in parallel, that is, is vertically arranged, knife spine is arcwall face, is made anti- Tissue will not be caused to damage to during rotation, only allow unidirectional cutting, cutting edge strength can be increased, played a protective role, improve The cutting efficiency of trepan, and extend the service life of trepan.

Description of the drawings

Fig. 1 is the stereogram of working sheath in the utility model trepan system embodiment.

Fig. 2 is the stereogram of expander in the utility model trepan system embodiment.

Fig. 3 is the sectional view of trepan in the utility model trepan system embodiment.

Fig. 4 is the partial perspective view of trepan in the utility model trepan system embodiment.

Fig. 5 is the stereogram of medical handle in the utility model trepan system embodiment.

Fig. 6 is the stereogram that handle is held in the utility model trepan system embodiment.

Fig. 7 is the sectional view that handle is held in the utility model trepan system embodiment.

Fig. 8 is the stereogram of sheath in the utility model trepan system embodiment.

Fig. 9 is the axial sectional view of sheath in the utility model trepan system embodiment.

Figure 10 is the radial cross-section of sheath in the utility model trepan system embodiment.

Figure 11 is the stereogram of loop coil in the utility model trepan system embodiment.

Figure 12 is the stereogram of ring in the utility model trepan system embodiment.

Figure 13 is the axial sectional view of ring in the utility model trepan system embodiment.

Figure 14 is the top view of medical handle in the utility model trepan system embodiment.

Figure 15 is sectional views of the Figure 14 at A-A.

Figure 16 is sectional views of the Figure 14 at B-B.

Figure 17 is the radial cross-section of medical handle in the utility model trepan system embodiment.

Figure 18 is the stereogram under the first working condition of the utility model trepan system embodiment.

Figure 19 is the stereogram under the second working condition of the utility model trepan system embodiment.

Figure 20 is the stereogram under the 3rd working condition of the utility model trepan system embodiment.

With reference to embodiments and its attached drawing the utility model is described in further detail.

Specific embodiment

Following embodiment primarily directed to the utility model trepan system, due to the utility model trepan system use The medical handle of the utility model, has included the explanation to medical handle in the explanation of trepan system embodiment.

Trepan system embodiment：

Referring to Fig. 1, Fig. 2, Fig. 3, Fig. 4 and Fig. 5, trepan system includes widened working sheath 1, step by step widened expansion step by step Device 2, step by step widened trepan 3, medical handle 4 and working sheath handle（It does not indicate）, working sheath handle is for fixing working sheath 1.The matrix of working sheath 1 is a cylinder 11, and the working end of working sheath 1 is duckbill 13, and the end of the working end of working sheath 1 is Arcwall face 12.

The matrix of trepan 3 is a cylinder 32, and the first end of cylinder 32 is working end, and the second end of cylinder 32 is fixed It is connected with connector 31, the end of connector 31 is recessed that there are two spacing bayonet 313, two spacing bayonets 313 vertically Axis centre on cylinder 32 is arranged symmetrically.Circumferentially raised landform circularizes the end lateral wall of the front end of connector 31 Positioning convex platform 311.Concave clamping slot 312 there are two being formed in the radial outer wall at 32 approximately axial middle part of cylinder, and two A clamping slot 312 is arranged symmetrically on the axis centre of connector 31.The working end of trepan 3 is provided with multiple blade parts, blade Portion is arranged circumferentially along trepan 3.Blade part includes blade 33 and knife spine 34, and blade 33 is connected with knife spine 34, blade 33 and The axis of trepan 3 is arranged in parallel, and knife spine 34 is arcwall face.

Referring to Fig. 6 to Figure 17, medical handle 4 is determined by sheath 43, holding handle 41, loop coil 45, the first locating bar 48, second Position stick 47, steel ball 46, ring 42, guide screw 44 are formed with hoodle screw 49.Steel ball 46 forms the clamping piece of the present embodiment.

Referring to Fig. 6 and Fig. 7, hold handle 41 and be made of mounting portion 412 and shank part 411, the shape of mounting portion 412 is similar Sphere, mounting portion 412 are located at the center of shank part 411 and are formed with shank part 411 T-shaped.Mounting portion 412 is equipped with installation Hole 416.Mounting portion 412 and the matched end face of first end of sheath 43 are equipped with the first accommodating chamber 414, mounting portion 412 and sheath 43 436 matched end face of the shaft shoulder is equipped with the second accommodating chamber 415, and the first accommodating chamber 414 is in 415 direction of the second accommodating chamber of direction Annular end face on open up there are two locating slot 413, two locating slots 413 are arranged symmetrically on the axis centre of mounting portion 412.

Referring to Fig. 8, Fig. 9 and Figure 10, the matrix of sheath 43 is cylinder 413, and the inner cavity of cylinder 413 is medical for accommodating The connector 31 of trepan 3.The first end of sheath 43 forms boss 432 along 413 lateral wall outwardly convex of cylinder, the boss 432 Fitting groove 433 there are two being opened up in the end face of the second extreme direction towards sheath 43, axis of two fitting grooves 433 along sheath 43 Line direction is arranged in bar shaped, and two fitting grooves 433 are arranged symmetrically on the axis centre of sheath 43.Positioned at cylinder 413 It concaves in the radial outer wall at approximately axial middle part and is formed with collar 434, set through side wall in collar 434 there are two circular hole 435, two circular holes 435 are arranged symmetrically on the axis centre of sheath 43.Positioned at collar 434 in the second end side towards sheath 43 To 413 lateral wall of cylinder on outwardly convex form the shaft shoulder 436, the shaft shoulder 436 is equipped with external screw thread.Exist positioned at collar 434 Inner shoulder table 441 is equipped with towards 431 madial wall of cylinder of the first extreme direction of sheath 43, inner shoulder table 441 is towards the axis of sheath 43 Heart direction protrusion.

It is set on 431 side wall of cylinder of the second end of sheath 43 there are two guide hole 440, guide hole 440 can be towards sheath 43 Radial direction open up or favour the radial direction of sheath 43 and open up.Axis centre symmetrical cloth of two guide holes 440 on sheath 43 It puts, and guide hole 440 is stepped hole.It concaves on 431 lateral wall of cylinder of the second end of sheath 43 and is formed with arc and leads To slot 442 and arc-shaped limit slot 437, arc guide groove 442 and arc-shaped limit slot 437 are positioned opposite on the axle center of sheath 43. Two guide holes 440, arc guide groove 442 and arc-shaped limit slot 437 can be located on same periphery or arc guide groove 442 and arc-shaped limit slot 437 where periphery and the periphery at two 440 places of guide holes differ.In arc-shaped limit slot 437 Equipped with clamping position portion 438 and release positioning region 439, clamping position portion 438 and release positioning region 439 are groove-like.Clamping Positioning region 438 and release positioning region 439 are located at arc-shaped limit slot 437 on the both ends of circumferencial direction, release 439 edge of positioning region respectively The circumferencial direction of sheath 43 is closer to guide hole 440, and the circumferential length of arc guide groove 437 is more than 438 He of clamping position portion Discharge the circumferential length between positioning region 439.

Referring to Figure 11, the matrix of loop coil 45 is torus 451, and the inner wall of torus 451 is formed with internal thread 452.

Referring to Figure 12 and Figure 13, the matrix of ring 42 is torus 421, its torus 421 is formed through on ring 42 The first screw hole 422 and the second screw hole 423, the first screw hole 422 and the second screw hole 423 are respectively about the axis of ring 42 The heart is positioned opposite.It is opened up on 421 inner wall of torus of ring 42 there are two arc groove 424, two arc grooves 424 distinguish position In the side of the first screw hole 422 and the second screw hole 423, and axis centre of two arc grooves 424 on ring 42 It is arranged symmetrically.Arc groove 424 is mutually being interconnected towards ring 42 by two sections of path parts and one section of large diameter portion in the radial direction Composition is connect, large diameter portion is located between two sections of small diameter portions point.

Referring to Figure 14, Figure 15, Figure 16 and Figure 17, the assembling process of medical handle 4 is：

（1）One end of first locating bar 48 is placed into the locating slot 413 for the mounting portion 412 for holding handle 41, first Locating bar 48 can be fixedly connected by way of being bonded or welding with holding the mounting portion 412 of handle 41, wherein the first locating bar 48 quantity is two；

（2）The circular hole 435 that second locating bar 47 is inserted into the collar 434 of sheath 43 is interior and stretches into the inner cavity of sheath 43 443, the second locating bar 47 can be fixedly connected by way of being bonded or welding with sheath 43, wherein the quantity of the second locating bar 47 For two；

（3）By the second end of sheath 43 from the first accommodating chamber 414 of mounting portion 412 towards the direction of the second accommodating chamber 415 It is inserted into mounting hole 416, in the fitting groove 433 of the other end insertion sheath 43 of the first locating bar 48, and the boss 432 of sheath 43 It is resisted against on the annular end face of the first accommodating chamber 414, and by the modes such as welding, being bonded by sheath 43 and hold handle 41 and fix Connection；

（4）External screw thread on the internal thread of loop coil 45 and the shaft shoulder 436 of sheath 43 is coordinated, and loop coil 45 is located at mounting portion In 412 the second accommodating chamber 415 and with being resisted against on the end face of the second accommodating chamber 415, so as to lock sheath 43；

（5）Steel ball 46 is put into the guide hole 440 of sheath 43, and ring 42 is placed on to the cylinder of the second end of sheath 43 Outside, 46 quantity of steel column in centre feed hole 440 can be multiple；

（6）422 thread fitting of the first screw hole of hoodle screw 49 and ring 42 is locked, makes the hoodle of hoodle screw 49 End is located in arc-shaped limit slot 437 and coordinates with clamping position portion 438 or release positioning region 439；By guide screw 44 with dialling 423 thread fitting of the second screw hole locking of ring 42, makes the end of guide screw 44 be located in arc guide groove 442, is hit by a bullet Pearl screw 49 is flat recess hoodle screw, and guide screw 44 is interior hexagonal step screw.

In the handle 4 after completing to assemble, along the circumferential direction of sheath 43, large diameter portion and the sheath 43 of arc groove 424 Medial surface between in the spacing radially of sheath 43 be more than or equal to the diameter of steel ball 46, the wall thickness of sheath 43 is less than steel ball 46 Diameter.When the hoodle end of hoodle screw 49 coordinates with clamping position portion 438, along the radial direction of sheath 43, the inner wall of ring 42 with Guide hole 440 is aligned, i.e., steel ball 46 is located at operating position；When the hoodle end of hoodle screw 49 coordinates with release positioning region 439, edge The radial direction of sheath 43, the large diameter portion of arc groove 424 are aligned with guide hole 440, i.e., steel ball 46 be located at can retraction position.

The connector 31 of trepan 3 is inserted into handle 4, forms medical trepan component, the wherein spacing bayonet of connector 31 313 and second locating bar 47 stretch into sheath 43 inner cavity 443 one end fits, and the positioning convex platform 311 of connector 313 against On the second end end face of sheath 43, steel ball 46 and the clamping slot 312 of connector 31 compress one by one in radial directions at this time.

When trepan 3 is prepared to be mounted on handle 4, ring 42 is rotated, drives guide screw 44 in arc guide groove 442 It is interior in rotary moving, while the hoodle end of hoodle screw 49 comes out out of clamping position portion 438, so as to the hoodle of hoodle screw 49 End is squeezed by the inner wall of arc-shaped limit slot 437, and hoodle screw 49 is in rotary moving in arc-shaped limit slot 437, until dialling Ring 42 drives hoodle screw 49 to rotate to the position for discharging positioning region 439, so as to hoodle screw 49 hoodle end itself It is reached under rebound effect in release positioning region 439.At this point, the large diameter portion of arc groove 424 is aligned with guide hole 440, i.e., Steel ball 46 can move in the cavity surrounded by large diameter portion with guide hole 440.During ring 42 rotates, from ring 42 Inner wall is smoothly transitioned into the path part of arc groove 424, then is smoothly transitioned into large diameter portion by path part, gradually Discharge the extruding force to steel ball 46.

At this point, the connector 31 of trepan 3 can be inserted into handle 4,313 and second locating bar of spacing bayonet of connector 31 47 stretch into the one end fits of the inner cavity 443 of sheath 43, realize and the displacement in 3 circumferential direction of trepan is defined, and connector 313 Positioning convex platform 311 be resisted against on the second end end face of sheath 43.Then ring 42 is reversely rotated, drives guide screw 44 in arc Contrarotation movement in shape guide groove 442, while the hoodle end of hoodle screw 49 comes out out of release positioning region 439, hoodle The hoodle end of screw 49 is squeezed by the inner wall of arc-shaped limit slot 437, and the rotation in arc-shaped limit slot 437 of hoodle screw 49 It is mobile, until ring 42 drives hoodle screw 49 to rotate to the position in clamping position portion 438, so as to the hoodle end of hoodle screw 49 Portion is reached under the rebound effect of itself in clamping position portion 438.At this point, extruding force of the steel ball 46 in the inner wall of ring 42 Effect lower part stretches out guide hole 440 and stretches into the inner cavity 443 of sheath 43, is pressed in the clamping slot 312 of trepan 3, to trepan 3 Axial movement carries out /V, and can be effectively prevented trepan 3 and be detached out of sheath 43, you can efficiently solves de- sheath problem. Also, when steel ball 46 is located at operating position, since the diametrical component of the restoring force of the hoodle end of hoodle screw 49 acts on, Effectively ensure that ring 42 is clamped.During ring 42 reversely rotates, arc groove 424 is by large diameter portion smoothly mistake It crosses to path part, then the inner wall of ring 42 is smoothly transitioned into from path part, the cooperation between structure is steadily reliable.

Use the operation method embodiment of trepan system：

Referring to Figure 18, Figure 19 and Figure 20, operation method includes：

（1）Using general puncture technique, i.e., using spinous process trailing edge in the incident point of waist side as entry point, to pathological interspinal Upper limb punctures after centrum below disk, and 5 percutaneous puncture of seal wire is incorporated into intervertebral foramen lower part interverbebral disc plane；

（2）Expander 2 is inserted in along seal wire 5, the working end of expander 2 is located at intervertebral foramen, and expander 2 is used to expand intervertebral Hole；

（3）Working sheath 1 is inserted in along the outer wall of expander 2, the working end of working sheath 1 is displaced downwardly to backbone processus articular superior veutro；

（4）After the completion of expander 2 expands intervertebral foramen, retain working sheath 1, take out expander 2；

（5）Trepan 3 is imported along the inner wall of working sheath 1, the working end of trepan 3 carries out rotatably cut-out processus articular superior abdomen Side seam matter completes intervertebral foramen and expands shaping.

The size of expander 2, working sheath 1 and trepan 3 can be to expand step by step, can be according to the different need of the size of intervertebral foramen It asks, carries out replacing the expander 2 of different set of dimensions, working sheath 1 and trepan 3 intervertebral foramen is expanded step by step.The ring of the utility model Saw 3 works positioned at 1 inner cavity of working sheath, is formed in processus articular superior basal part, there is sufficient formingspace, away from outlet Nerve root avoids its damage；Closer to traveling nerve root, more effective nerve root decompression can be carried out；The position hypertrophy of ligamentum flavum, It shields between 3 end of trepan and traveling nerve root, avoids traveling nerve root injury；Traveling nerve root is in the level one As sent from dural sac, have stronger pain feedback mechanism, operation safety can be further improved；Avoid damage to upper joint The capsular ligament and plica synovialis of prominent tip, avoid or reduce the generation of postoperative traumatic facet syndrome.

Embodiment described above, simply the utility model preferred embodiments, be not to limit the utility model practical range, Therefore the equivalent change or modification that all construction, feature and principles according to described in present utility model application the scope of the claims are done, it should all wrap It includes in the utility model patent application range.

Claims (9)

1. medical handle, including holding handle, the sheath being fixedly connected with the holding handle and institute can be sleeved on the relative rotation State the ring in sheath, it is characterised in that：

Clamping piece is provided in the sheath, the clamping piece, can be in operating position and retraction position under the action of the ring Shift in position is realized between putting；

The retraction position is than the operating position on the radial further from the pivot of the ring.

2. handle according to claim 1, it is characterised in that：

The inner wall of the ring is equipped with arc groove；

When the clamping piece is located at the operating position, the inner wall of the ring is aligned with the clamping piece；

When the clamping piece is located at the retraction position, the arc groove is aligned with the clamping piece.

3. handle according to claim 1, it is characterised in that：

The outer wall of the sheath is equipped with limiting slot, and clamping position portion and release positioning region are equipped in the limiting slot；

The ring is equipped with hoodle screw, and the hoodle end of the hoodle screw is located in the limiting slot；

When the clamping piece is located at the operating position, the hoodle end coordinates with the clamping position portion；

When the clamping piece is located at the retraction position, the hoodle end and release positioning region cooperation.

4. handle according to claim 3, it is characterised in that：

The ring is equipped with guide screw, and guide groove, the guide groove and the /V are additionally provided on the outer wall of the sheath Slot is positioned opposite with the axle center of the sheath, and the end of the guide screw is located in the guide groove.

5. handle according to any one of claims 1 to 4, it is characterised in that：

The sheath is equipped with the locating bar for stretching into the sheath inner cavity.

6. handle according to claim 5, it is characterised in that：

Loop coil is cased in the sheath, the loop coil is connected through a screw thread with the sheath.

7. trepan system, including widened working sheath step by step, widened expander, step by step widened trepan and working sheath step by step Handle, the working sheath handle are used to fix the working sheath, it is characterised in that：

The trepan system further includes to fix the medical handle of the trepan, and the medical handle is claim 1 to 6 The medical handle of any one.

8. trepan system according to claim 7, it is characterised in that：

The working end of the working sheath is duckbill, and the end of the working end is arcwall face.

9. the trepan system according to claim 7 or 8, it is characterised in that：

The working end of the trepan is provided with multiple blade parts, and the blade part is arranged circumferentially along the trepan；

The blade part includes blade and knife spine, and the blade is connected with the knife spine, the axis of the blade and the trepan It is arranged in parallel, the knife spine is arcwall face.