JP2008067810A - Auxiliary device for portal production - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a device capable of accurately and quickly producing a portal since it takes time and labor for work though step cannulation of widening a hole positioned by a needle and a wire by changing it with the cannula of a larger size gradually and attaining a portal is known for the production of a portal when performing a scopic surgery such as shoulder arthroscopic surgery. <P>SOLUTION: The cylindrical auxiliary device provided with a guide for making a scalpel follow it is provided. By passing a wire puncturing a position at which the portal is required to be produced beforehand in a through-hole at the center of the auxiliary device, advancing a scalpel along the guide provided on the surface of the auxiliary appliance and performing incision, a portal is produced. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to an auxiliary instrument for easily making a small hole into which a surgical instrument or the like is inserted, that is, a small portal, by incising a scalpel. In particular, the present invention relates to an auxiliary device suitable for producing a portal in an endoscopic operation using an arthroscope or an endoscope.

  In joint surgery represented by endoscopic surgery, in addition to the method of performing direct incision with a large incision around the joint, a plurality of small holes or portals that reach the joint capsule are opened to visually recognize the inside of the joint. Arthroscopic surgery in which an arthroscope or an endoscope or a surgical instrument is inserted to perform surgery is known. This operation has advantages such as a narrower incision width, less noticeable surgical scars, and less pain after the operation compared to direct-viewing.

  However, in a surgical operation under the endoscopic condition, such as a shoulder joint operation, where the distance to the joint capsule that wraps the joint portion of the joint is about 3 cm to 5 cm, an accurate operation portal for inserting the surgical tool is used. It is not easy to make at an angle and position. For this reason, portal production work is required in several stages so as not to create unnecessary portals.

  For example, it is known to produce a working portal according to the following procedures [1] to [6] in the shoulder arthroscopic surgery (shoulder arthroscopic surgery). [1] A portal is created at a position where the surgical site in the joint capsule can be mirrored without interfering with the surgical operation, and the arthroscope is inserted (the portal position and angle are more acceptable than the working portal). Because it is wide, it is relatively easy.) [2] While observing the inside of the joint capsule with the inserted arthroscope, trial puncture is performed with a catalan needle having an outer diameter of about 0.6 mm to 0.9 mm, and an accurate position and location are determined. [3] Using the same mirror, determine the position and angle of the portal with a needle that is slightly larger than the cattellan needle (sometimes it can be omitted). [4] A Kirschner wire having a diameter of about 1.8 mm is inserted in parallel with the needle or the cattellan needle. [5] A cylindrical cannula (cylinder for expanding and maintaining the portal) is inserted along the Kirschner wire. [6] The cannula is gradually replaced with a larger one (this operation is called step cannulation, and the cannula is sequentially replaced with a larger one by about 1 mm). In this way, a working portal having a diameter of about 1 cm to 2 cm can be produced at an appropriate position and angle.

  As described above, since it takes time to produce a working portal for endoscopic surgery, an auxiliary device that is an alternative to the step of step cannulation and that can expand the portal without sequential replacement is known (Patent Literature). 1).

Japanese Patent Application No. 2005-319063

As described above, since it is not easy to produce a working portal for endoscopic surgery, it has been desired to develop an instrument for producing a working portal quickly and accurately. The step cannulation, which is a conventional technique, and the technique shown in Patent Document 1 are used to expand a small hole made of a wire with a cannula to form a portal. In addition, it was necessary to repeat the same operation for expanding the hole.
An object of the present invention is to produce a portal that facilitates the production of the portal and facilitates the re-installation when the cannula comes out. Specifically, an object of the present invention is to provide an auxiliary instrument that serves as a guide for advancing a female tooth in order to produce a portal by cutting a female knife.

  In order to solve the above-described problems and achieve the object of the present invention, the present invention has a substantially cylindrical body having a hole through which a wire can be passed through a central portion, and the surface axial direction of the substantially cylindrical body An auxiliary device for portal preparation is provided, which is provided with a groove for guiding a medical knife.

  Moreover, according to the preferable aspect of this invention, it is desirable that the hole which can pass a wire is a hole which can pass a Kirschner wire.

  Moreover, according to the preferable aspect of this invention, it is desirable to provide the arm for hold | gripping on the surface of a substantially cylindrical body.

  Moreover, according to the preferable aspect of this invention, it is desirable for the groove | channel which guides a medical knife to make a V-shaped cross section.

  Moreover, according to the preferable aspect of this invention, it is desirable to use for the surgery of a shoulder joint or a hip joint.

  The portal-use auxiliary device of the present invention is used in such a manner that a hole provided in the center of a substantially cylindrical body is passed through a wire previously set in a patient. The auxiliary tool for portal preparation passed through the wire slides the knife along the groove provided in the surface axial direction of the substantially cylindrical body. Thereby, a portal can be easily produced at a desired position and angle by incision of a scalpel. The cannula can be easily installed by creating a portal by incising a scalpel using the auxiliary instrument of the present invention.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. Note that the present invention is not limited thereby.

(First embodiment)
In FIG. 1, the outline of the auxiliary tool 10 for portal production concerning 1st Embodiment is shown. A groove 3 is provided along the axial direction of the substantially cylindrical body on the surface of the substantially cylindrical body 1 provided with a through hole 2 having an outer diameter of 5 mm and a diameter of 2 mm. The through hole 2 is a hole through which a Kirschner wire having an outer diameter of 1.8 mm can be passed. The diameter of the through-hole 2 is not specifically limited, For example, it is desirable to set it as a diameter 10-20% larger than the diameter of a wire according to the diameter of the wire to be used. Specifically, it is considered that it is preferable for shoulder arthroscopic surgery to select an auxiliary instrument depending on the diameter of the wire to be used in the range of 1 to 3 mm as the diameter of the through hole 2, but for applications other than shoulder arthroscopic surgery. If there is, it is desirable to change the size of the diameter according to the application.

Further, an arm 4 for gripping is provided near one end of the substantially cylindrical body 1 in the axial direction. The substantially cylindrical body 10 may have a polygonal shape or an elliptical shape in addition to a shape whose cross section is close to a perfect circle as shown in FIG. Moreover, the groove | channel 3 should just be a shape which can follow a knife, and besides the V-shaped cross section shown in FIG. 1, a U-shaped cross section as shown in FIG. The shape is not limited as long as it is suitable for keeping the shape.
In addition, the material of the auxiliary instrument 10 will not be specifically limited if it is a material suitable for the objective of this invention. For example, it is conceivable to use stainless steel or titanium alloy as the metal material, or to use a hard synthetic resin in addition to the metal. Moreover, although the axial direction length of the substantially cylindrical body 1 of the auxiliary instrument 10 is not particularly limited, a length of 3 to 10 cm, more preferably 5 to 8 cm can be selected.

Next, a usage example of the auxiliary instrument 10 will be described. First, as shown in FIG. 3, the Kirchner wire 20 having an outer diameter of 1.8 mm is passed through the through hole 2 of the auxiliary device 10 and brought into contact with the patient 30. It is assumed that the Kirschner wire 20 has reached the patient's shoulder joint capsule at an appropriate position and angle.
Next, as shown in FIG. 4, the medical knife 40 is slid along the groove 3 toward the patient, and the shoulder is cut open. At this time, when the doctor holds the auxiliary instrument 10 with the arm 4, the doctor can easily perform the operation. When the portal is created by incision of the scalpel 40, the auxiliary device 10 can be appropriately advanced along the Kirschner wire 20 into the body. In this way, the portal through the incision of the knife 40 is made to reach into the joint capsule. When the portal reaches into the joint capsule, the auxiliary device 10, the Kirschner wire 20, and the knife 40 are taken out of the body, and a cannula is installed in the produced portal.

  The present invention can be applied not only to arthroscopic surgery for shoulder joints but also to arthroscopic surgery for hip joints where the distance from the outer skin to the joint capsule is not short. Moreover, it can be used suitably when it is desired not only to joint surgery and endoscopic surgery but also to create a portal into the body for some purpose.

  Hereinafter, the present invention will be described with reference to examples.

  The photograph of the auxiliary tool 10 for portal manufacture produced in Example 1 is shown to Fig.5 (a) (b). The material of the auxiliary device 10 is stainless steel, and a groove 3 having a V-shaped cross section with a side length of 2 mm is formed on the surface of the substantially cylindrical body 1 having a diameter of the through-hole 2 of 2 mm and an axial length of 6 mm. Welded. Also, an arm 4 for gripping a ring made of stainless steel is welded to the end. Moreover, in order to improve the visibility at the time of a surgery, the light blue marking 5 is provided in a part of surface of the substantially cylindrical body 1 in which the groove | channel 3 is provided.

1 is a schematic view of one embodiment of an auxiliary device of the present invention. 1 is a schematic view of one embodiment of an auxiliary device of the present invention. It is explanatory drawing of the usage example of the auxiliary tool of this invention. It is explanatory drawing of the usage example of the auxiliary tool of this invention. (A) (b) It is a photograph of the auxiliary instrument in an Example.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Substantially cylindrical body 2 ... Through-hole 3 ... Groove 4 ... Arm 5 ... Marking 10 ... Auxiliary appliance 20 for portal preparation ... Kirschner wire 30 ... Patient 40 ... Female

Claims (5)

An auxiliary device for portal preparation characterized by having a substantially cylindrical body with a hole through which a wire can be passed in the center and having a groove for guiding a medical knife in the surface axial direction of the substantially cylindrical body . The auxiliary tool for portal preparation according to claim 1, wherein the hole through which the wire can pass is a hole through which the Kirschner wire can pass. The portal manufacturing auxiliary device according to claim 1, wherein an arm for gripping the surface of the cylindrical body is provided. The auxiliary tool for portal preparation according to any one of claims 1 to 3, wherein the groove for guiding the medical knife has a V-shaped cross section. The auxiliary device for portal preparation according to any one of claims 1 to 4, which is used for surgery of a shoulder joint or a hip joint.

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