JP2006314744A - Transparent trocar for brain puncture - Google Patents

Transparent trocar for brain puncture Download PDF

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Publication number
JP2006314744A
JP2006314744A JP2005168824A JP2005168824A JP2006314744A JP 2006314744 A JP2006314744 A JP 2006314744A JP 2005168824 A JP2005168824 A JP 2005168824A JP 2005168824 A JP2005168824 A JP 2005168824A JP 2006314744 A JP2006314744 A JP 2006314744A
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Prior art keywords
mantle
cannula
endoscope
brain
puncture
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Japanese (ja)
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Shizuo Oi
静雄 大井
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IR MEDICAL KOBO KK
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IR MEDICAL KOBO KK
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Priority to JP2005168824A priority Critical patent/JP2006314744A/en
Priority to PCT/JP2006/309284 priority patent/WO2006121028A1/en
Publication of JP2006314744A publication Critical patent/JP2006314744A/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00131—Accessories for endoscopes
    • A61B1/00135—Oversleeves mounted on the endoscope prior to insertion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/313—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes
    • A61B1/317—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes for bones or joints, e.g. osteoscopes, arthroscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/361—Image-producing devices, e.g. surgical cameras

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Pathology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Biophysics (AREA)
  • Physics & Mathematics (AREA)
  • Radiology & Medical Imaging (AREA)
  • Optics & Photonics (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Surgical Instruments (AREA)
  • Endoscopes (AREA)

Abstract

<P>PROBLEM TO BE SOLVED: To provide an excellent trocar for brain puncture which is used for an operation to treat an intracerebral lesion at a deep part of the brain. <P>SOLUTION: When there is an abnormality in a scalp, it can be found out from a pointed head of an outer cannula during the puncture to the lesion by making the outer cannula 1 transparent. Since an inner cannula 2 is transparent and has an inner diameter large enough for the insertion of an endoscope, the article of this invention can be observed until it is made to reach the inside of a cerebral ventricle and the safety can be secured. The direction of the endoscope can be easily recognized by a vertical line 3 from the pointed head of the outer cannula 1. By making a pointed head of the inner cannula 2 which is exposed from the outer cannula 1 short, the damage of surrounding tissues of the cerebral ventricle can be prevented. Also, by boring two holes 4 at both sides of the pointed head of the inner cannula 2, the function is not detracted even when one of the holes is clogged. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

本発明は、脳深部にある脳内病変を治療する手術に使用される脳穿刺用套管針に関する。  The present invention relates to a cerebral puncture trocar used in surgery for treating intracerebral lesions deep in the brain.

従来の脳穿刺用套管針は色調を帯びているため、神経内視鏡を外套を通して病変部へ押し進める際、外套を抜けるまで脳の状態を観察できなかった。観察が出来ないことにより、外套先端よりも頭皮側にある脳の異常または出血を認識できなかった。  Since the conventional cerebral puncture trocar has a color tone, when the neuroendoscope is pushed through the mantle to the lesion, the state of the brain cannot be observed until the mantle is removed. Due to the inability to observe, brain abnormalities or bleeding on the scalp side of the mantle tip could not be recognized.

内視鏡、特に柔性鏡を外套先端よりも押し進め病変部などを観察していると、画面上の上下と実際の生体の上下の関係を見失う状態に陥り、正確な画像診断やそのまた更に奥へのアプローチをすることが困難であった。  When an endoscope, especially a flexible endoscope, is pushed beyond the tip of the mantle to observe the lesion, the relationship between the top and bottom of the screen and the top and bottom of the actual living body is lost. It was difficult to approach.

脳室に脳脊髄液が溜まる水頭症の治療の際、内視鏡を脳の深部にある脳室まで送り込む必要がある。内套が外套に挿入された状態で脳室まで押し進め、内套先端に開けられた穴に脳脊髄液が流入し、それが内套末端より噴出したことを確認することにより脳室到達を判断する。到達すると内套が外套より抜かれ、内視鏡が外套を通し挿入される。しかし脳室、特に小児の脳室は小さく、外套から突き出している内套先端が従来の様に長いと、繊細な周辺組織を損傷する恐れがある。また従来のものは内套先端に穴が一つしかなく、異物により根詰まりを起こした場合、脳室に到達したかどうか見誤る危険性があった。  In the treatment of hydrocephalus, where cerebrospinal fluid accumulates in the ventricle, it is necessary to send the endoscope to the ventricle deep in the brain. Pushing to the ventricle with the inner cannula inserted into the outer cannula, determining that cerebrospinal fluid has flowed into the hole at the tip of the inner cannula and ejected from the distal end of the inner cannula To do. Upon reaching, the inner cannula is removed from the outer cannula, and the endoscope is inserted through the outer cannula. However, the ventricle, especially the cerebral ventricle of a child, is small, and if the tip of the inner cannula protruding from the outer cannula is long as in the prior art, delicate peripheral tissues may be damaged. In addition, the conventional one has only one hole at the tip of the mantle, and when a clogging occurs due to a foreign substance, there is a risk of misunderstanding whether or not it has reached the ventricle.

以上に述べた欠点は、手術操作が順調に施行されることを妨げ、患者の生命に対する危機をもたらすなど、患者にとって不利益を被らせていた。本発明はこれらの欠点を解決し、患者への貢献をもたらすために発明されたものである。  The drawbacks described above have suffered disadvantages for the patient, such as preventing the surgical operation from being performed smoothly and causing a crisis to the patient's life. The present invention was invented to solve these drawbacks and to contribute to the patient.

外套１、内套２、共に透明な素材にする事により、内視鏡を外套１を通して挿入する際、外套１に接する脳の状態を観察でき、更なる安全性が確保される。  By making both the mantle 1 and the mantle 2 transparent materials, when the endoscope is inserted through the mantle 1, the state of the brain in contact with the mantle 1 can be observed, and further safety is ensured.

また内套２の内軸に更に細径の内視鏡を挿入できる適度な内径を有することにより、本発明を脳実質を穿刺し脳室に到達させる際にも、この内部に挿入された内視鏡によって観察することが可能になりより安全な穿刺が行える。  In addition, since the inner shaft of the inner cannula 2 has an appropriate inner diameter that allows insertion of a smaller-diameter endoscope, when the present invention punctures the brain parenchyma and reaches the ventricle, It is possible to observe with an endoscope, and safer puncture can be performed.

外套１の両側３時と９時の部分に、先端部より中央部にかけ縦線３を入れることにより、画面上の上下と実際の生体の上下を見失わず、病変部へのアプローチを容易にする。これは内視鏡を外套１まで引いてくると縦線３が見えるため、上下の判断が可能になるからである。  By placing a vertical line 3 at the 3 o'clock and 9 o'clock sides of the mantle 1 from the tip to the center, the top and bottom of the screen and the top and bottom of the actual living body are not lost, making it easy to approach the lesion. . This is because when the endoscope is pulled to the mantle 1, the vertical line 3 can be seen, so that it is possible to make an up / down determination.

外套１から出ている内套２先端部を短くすることにより、脳室周辺組織への損傷を防ぐことが可能になる。水頭症の患者の脳室に到達した際、内套２の先端に開けられた穴から脳骨髄液が流入し、内套２の末端からその液が溢れ出すことにより到達を確認する。内套２の先端部が長いと、穴が脳室に達する前に内套２の先端が脳室周辺組織に接触し傷つける場合がある。内套２の先端部を短くすることによりこの事故を回避する。また内套２の先端に開けられた穴４のどちらか一方が異物により根詰まりしても、もう一方の穴から脳骨髄液が流入することにより、脳室到達を確実に確認し、周辺組織への損傷を回避する。  By shortening the distal end portion of the inner cannula 2 protruding from the outer mantle 1, it becomes possible to prevent damage to the tissue around the ventricle. When reaching the cerebral ventricle of a hydrocephalus patient, the cerebrobone marrow fluid flows from a hole formed in the tip of the inner cannula 2 and the arrival is confirmed by overflowing the liquid from the end of the inner cannula 2. If the distal end of the inner cannula 2 is long, the distal end of the inner cannula 2 may come into contact with and damage the ventricular peripheral tissue before the hole reaches the ventricle. This accident is avoided by shortening the tip of the inner sleeve 2. In addition, even if one of the holes 4 formed at the tip of the inner sleeve 2 is clogged by a foreign substance, the cerebrospinal fluid flows from the other hole, thereby confirming that the ventricle has reached the surrounding tissue. Avoid damage to.

上述したように本発明は、脳神経内視鏡手術の際に脳の状態が確認でき、内視鏡がどの方向を向いているかの判断を可能にし、脳組織の損傷を防ぐ脳穿刺用套管針を提供できる。  As described above, the present invention provides a cerebral puncture cannula that can confirm the state of the brain during neuroendoscopic surgery, determine which direction the endoscope is facing, and prevent damage to brain tissue Can provide a needle.

以下、本発明の実施の形態を図１〜図５に基づいて説明する。  Hereinafter, embodiments of the present invention will be described with reference to FIGS.

外套１に内套２を装着する。（図面１）  The inner cannula 2 is attached to the outer cannula 1. (Drawing 1)

この状態で内視鏡を内套２に挿入し、病変部へ押し進める。病変部へ到達した際内套２を外套１から抜き取る。（図面３）  In this state, the endoscope is inserted into the inner cannula 2 and pushed forward to the lesioned part. When reaching the lesion, the inner cannula 2 is removed from the outer cannula 1. (Drawing 3)

外套１に沿って内視鏡、その他の治療のための機器を挿入し、内視鏡画像を見ながら病変を治療する。（図面４）以上のように本発明を使用すれば、生命への危機を回避することが出来る。  An endoscope and other treatment devices are inserted along the mantle 1 to treat the lesion while viewing the endoscope image. (Drawing 4) If the present invention is used as described above, a crisis to life can be avoided.

外套の断面図、外套と内套及び内套が外套に装着されている外観図Cross-sectional view of the mantle, external view of the mantle and inner mantle and inner mantle attached to the mantle 外套と内套の先端部拡大図Enlarged view of the tip of the mantle and mantle 本発明による穿刺の模式図Schematic diagram of puncture according to the present invention 手術模式図Surgery schematic diagram

符号の説明Explanation of symbols

１ 外套
２ 内套
３ 縦線
４ 穴
５ 外套断面図1 Outer Jacket 2 Inner Jacket 3 Vertical Line 4 Hole 5 Outer Cross Section

Claims (4)

透明な素材で作られる円柱形の外套１と、その外套１に挿入可能な内套２から構成される脳穿刺用套管針。  A trocar for cerebral puncture composed of a cylindrical mantle 1 made of a transparent material and an inner mantle 2 that can be inserted into the mantle 1. 内套２はその中軸にさらに細径の内視鏡を挿入できる適度な内径を有する、請求項１の製造装置。  The manufacturing apparatus according to claim 1, wherein the inner sleeve 2 has an appropriate inner diameter into which an endoscope having a smaller diameter can be inserted into a central shaft thereof. 外套１の側面３時と９時の部分に先端から中央部にかけ縦線３が付けられる、請求項１．２の製造装置。  The manufacturing apparatus according to claim 1.2, wherein a vertical line 3 is attached from the tip to the center at the 3 o'clock and 9 o'clock portions of the jacket 1. 外套１から突き出している内套２の先端部分が従来のものより短くされ、２つの穴４が両側に開けられる、請求項１．２．３．の製造装置。  The tip portion of the inner cannula 2 protruding from the outer mantle 1 is shorter than the conventional one, and the two holes 4 are opened on both sides. Manufacturing equipment.
JP2005168824A 2005-05-12 2005-05-12 Transparent trocar for brain puncture Withdrawn JP2006314744A (en)

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JP2005168824A JP2006314744A (en) 2005-05-12 2005-05-12 Transparent trocar for brain puncture
PCT/JP2006/309284 WO2006121028A1 (en) 2005-05-12 2006-05-09 Transparent trocar for use in cephalocentesis

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US20110301411A1 (en) * 2009-12-04 2011-12-08 Brannon James K Fluidic endoscope tip locator
JP2014534853A (en) * 2004-10-28 2014-12-25 ニコ コーポレイションＮＩＣＯ Ｃｏｒｐｏｒａｔｉｏｎ Surgical access system
CN104248464A (en) * 2014-09-24 2014-12-31 浙江大学 Multiple-target-point stereotaxis aspiration trocar
US20150031956A1 (en) * 2012-03-22 2015-01-29 DePuy Synthes Products, LLC Fluid management catheter and methods of using same
US10307183B2 (en) 2011-10-24 2019-06-04 Nico Corporation Surgical access system with navigation element and method of using same
US10449340B2 (en) 2004-10-28 2019-10-22 Nico Corporation Surgical access assembly and method of using same
US11284917B2 (en) 2011-10-24 2022-03-29 Nico Corporation Surgical access assembly and method of using same

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EP2082682A3 (en) * 2008-01-24 2009-12-23 Karl Storz GmbH & Co. KG Operating anoscope for transanal endoscopic microsurgery
CN102614012B (en) * 2012-03-14 2013-12-25 陈晓雷 Endoscope guiding device
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US5454790A (en) * 1994-05-09 1995-10-03 Innerdyne, Inc. Method and apparatus for catheterization access
JP2000287915A (en) * 1999-04-08 2000-10-17 Machida Endscope Co Ltd Guide tube device for surgery
US6607561B2 (en) * 2001-10-02 2003-08-19 James Kevin Brannon Biaxial core compression
JP3743512B2 (en) * 2002-07-30 2006-02-08 株式会社八光 Surgical mantle

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JP2014534853A (en) * 2004-10-28 2014-12-25 ニコ コーポレイションＮＩＣＯ Ｃｏｒｐｏｒａｔｉｏｎ Surgical access system
US10449340B2 (en) 2004-10-28 2019-10-22 Nico Corporation Surgical access assembly and method of using same
US11464539B2 (en) 2004-10-28 2022-10-11 Nico Corporation Surgical access assembly and method of using same
US11864793B2 (en) 2004-10-28 2024-01-09 Nico Corporation Surgical access assembly and method of using same
US11969187B2 (en) 2004-10-28 2024-04-30 Nico Corporation Surgical access assembly and method of using same
US20110301411A1 (en) * 2009-12-04 2011-12-08 Brannon James K Fluidic endoscope tip locator
US10307183B2 (en) 2011-10-24 2019-06-04 Nico Corporation Surgical access system with navigation element and method of using same
US11284917B2 (en) 2011-10-24 2022-03-29 Nico Corporation Surgical access assembly and method of using same
US20150031956A1 (en) * 2012-03-22 2015-01-29 DePuy Synthes Products, LLC Fluid management catheter and methods of using same
US9848764B2 (en) * 2012-03-22 2017-12-26 Integra Lifesciences Switzerland Sàrl Fluid management catheter and methods of using same
AU2017248500B2 (en) * 2012-03-22 2019-05-09 Integra LifeSciences Switzerland Sarl Fluid management catheter and methods of using same
CN104248464A (en) * 2014-09-24 2014-12-31 浙江大学 Multiple-target-point stereotaxis aspiration trocar

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