JPH0624537B2 - Brain surgery device - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial application] The present invention is used in intracranial surgery,
In particular, the present invention relates to a device for performing treatment such as suction removal of an injured portion such as intracerebral hemorrhage or brain tumor.

[Problems to be Solved by Prior Art and Invention] Cerebral vascular disorders include cerebral hemorrhage and subarachnoid hemorrhage. In order to remove these intracerebral hematomas and the like after the intracerebral hemorrhage, in recent years, for example, the localization by the CT (Computer Tomograph) induction method shown in “Neurosurgery”, Vol. 14, No. 2, February 1986. Brain surgery is being performed.

Stereotactic brain surgery is a stereotactic brain surgery device that is fixed to the patient's head, and the positioning device provided in this device positions the lesion in the brain, and a treatment tool such as a drainage tube is placed on the lesion. Insert and perform surgery, but C
By using the T to capture and position the obstacle part by a tomographic image, the positioning accuracy is improved and the invasion to the patient can be suppressed.

The surgical device used for this stereotactic brain surgery is Japanese Patent Publication Sho 61-2.
It is disclosed in Japanese Patent No. 5377. This is a technique in which a target surgical site in the brain is determined by CT, a sheath is punctured at the target point by a surgical device attached to the skull, and a hematoma or the like is suctioned and removed through the sheath.

By the way, as a method of removing intracerebral hematoma by stereotactic brain surgery, a method of inserting a metal suction tube into the hematoma and sucking and removing the hematoma with an aspirator such as a syringe is performed. If it cannot be completely removed by this method, the indwelling tube is left in the hematoma cavity, a hematolytic agent such as urokinase is injected, and after several hours, the dissolved hematoma is removed by suction from the indwelling tube. A hematolysis method is used. Further, in recent years, a method of crushing a hematoma using an ultrasonic suction device and removing it by suction is being used. In addition, biopsy of brain tumor, ablation treatment with Nd-YAG laser light, and the like are performed by stereotactic brain surgery.

By the way, in removing stereotactic intracerebral hematoma by the CT induction method, the status of hematoma aspiration cannot be observed in real time, which is a blind surgical operation, so that there is a very high risk of damaging the brain parenchyma. Sometimes the hematoma in the brain cannot be completely removed by not doing so. Furthermore, since the surgical operation must be carried out while sequentially confirming the hematoma suction state by CT in order not to damage the brain parenchyma, the operation time becomes extremely long and the patient is greatly invaded. In addition, the operator's fatigue becomes extremely large.

The method of sucking and removing hematoma with an aspirator such as a syringe has the risk of sucking the brain parenchyma due to suction pressure due to the highly viscous property of the hematoma, and the hematoma is easily clogged in the suction tube lumen. The problem is that we often have to interrupt surgery. The diameter of the suction tube must be increased in order to prevent the hematoma from becoming clogged, and therefore, when the brain parenchyma is damaged, the degree of damage is increased.

In the hematolytic method, the dissolving ability of hematolytic agents is very small,
There is a risk that an infectious disease may be caused by long-term catheter placement or frequent administration of a dissolution agent without a clinically satisfactory condition, and the long-term catheter placement causes great pain to the patient.

Although the method using the ultrasonic suction device is very effective, there is a risk of damaging the brain parenchyma by a blind operation, and there is no device that can fix the ultrasonic suction device and can be operated forward and backward. There is a risk that the brain parenchyma may be damaged due to an erroneous operation because the user has to carry out the forward / backward operation while holding.

The above problems were common to conventional stereotactic brain surgery, such as surgery for brain tumors as well as suction removal of intracerebral hematomas.

[Object of the Invention] The present invention has been made in view of the above circumstances, and is capable of reliably positioning and holding a surgical instrument and adjusting the position of the surgical instrument with respect to the head of a patient with high accuracy. An object is to provide a surgical device.

[Means and Actions for Solving Problems] A brain surgery apparatus of the present invention is a support tool that is fixed to a stereotactic brain surgery apparatus to support a sheath, a telescope, and a treatment tool, and a sheath for the support tool. And a slide device capable of moving the telescope and the treatment tool as one unit back and forth with respect to the insertion direction.

That is, the stereotactic brain surgery device fixes the insertion direction,
The treatment instrument is inserted by the slide device.

Embodiments Embodiments of the present invention will be described below with reference to the drawings.

1 to 18 relate to a first embodiment of the present invention,
FIG. 1 is a sectional view of the slide device, and FIG. 2 is A- in FIG.
Sectional view in the A'direction, FIG. 3 is an external view of the slide device, and FIG.
FIG. 5 is a perspective view of the fixing device, FIG. 5 is a cross-sectional view of the fixing device, FIG. 6 is a cross-sectional view taken along the line BB ′ of FIG. 5, FIG. 7 is an explanatory view of the sheath holder, and FIG. 7 is a sectional view taken along the line CC ′ of FIG.
9 is a sectional view taken along the line DD ′ of FIG. 8, FIG. 10 is an explanatory view of the configuration of the telescope, FIG. 11 is an explanatory view of the configuration of the adapter, and FIG. 12 is the sliding state of FIG. Illustration,
13 is a sectional view of a supporting body, FIG. 14 is a sectional view of a supporting body fixed with a presser belt, FIG. 15 is a sectional view of a supporting body fixed with a pressing arm, FIG. 16 is a sectional view of a sheath,
FIG. 17 is an external view of the mandolin, and FIG. 18 is an overall configuration diagram of the brain surgery device.

In FIG. 18, the brain surgery device 1 is composed of a sheath 2, a telescope 3, an adapter 4, a stereotactic brain surgery device 5, an ultrasonic suction device 6 as a treatment tool, a fixing device 7, and a generator 8.

The head 9 of the patient is inserted into the ring 11 of the stereotactic brain surgery device 5, and is fixed to the stereotactic brain surgery device 5 by the four head fixing pins 12 provided on the ring 11. It has become. On one side of the ring 11, X, Y, Z
A positioning device 13 which is slidable in the direction and rotatable in the α direction is provided, and a curved arm 14 is connected to the positioning device 13. The sheath 2 is provided on the arm 14 so as to be slidable in the β direction.
Further, on the top of the ring 11, there is provided a fixing device 7 in which a curved arm 16 for holding the sheath 2 is continuously provided together with the arm 14.

The sheath 2 is held by a sheath holder 17 by an arm 14 and an arm 16. Further, the sheath holder 17 supports the slide device 19 via the support 18.

The sheath 2 is connected to the telescope 3 having an eyepiece 21 extending obliquely rearward from the side, and further to the rear of the telescope 3, the ultrasonic suction device 6 is connected. The adapter 4 is provided. The telescope 3 is provided with a light guide 22 that can supply illumination light.
Is connected to the sheath 2, and a water supply tube 23 capable of supplying a perfusate such as physiological saline is connected to the sheath 2.

A cord 24 and a drainage tube 26 extend from the rear end of the ultrasonic suction device 6, the cord 24 is connected to the generator 8, and the drainage tube 26 is connected to the generator 8.
Connected to a collection bin 27 that collects the drainage attached to the. The tube 28 extending from the collecting bottle 27 is connected to a drain container (not shown) via a pump 29.

4 to 6, the fixing device 7 includes a ring 11
A fixed base 3 having a sliding surface 31 which is fixed to the bed by a fixing screw 34 and which is parallel to the bed surface on which the patient is not shown.
Equipped with 2. A slide table 33 is provided which is slidable on the sliding surface 31 in the X direction. This slide stand 3
3 is fixed to the fixing base 32 by a fixing screw 36. The slide base 33 has a support base 37 so as to be slidable in the Z direction, and the support base 37 is fixed by a fixing screw 38. A cylindrical support pillar 39 is provided on the upper surface of the support base 37, and a lower portion of a cylindrical rotation cylinder 41 is fitted on the support pillar 39. The rotary cylinder 41 is rotatable in the θ direction around the support pillar 39, and can be fixed to the support pillar 39 by a fixing screw 42. Further, a groove 43 that is open to the upper surface and the side surface is provided in the upper portion of the rotary cylinder 41, and an arm holding plate 46 provided with a slot groove 44 is sandwiched in the groove 43. Has become. Further, the arm 16 is sandwiched between the arm holding plates 46. A shaft 47 penetrates the rotary cylinder 41 and the arm holding plate 46, and the arm 16 is fixed by screwing a knob 48 into the tip of the shaft. By loosening the knob 48, the arm 16 can be slid in the γ direction and can be further rotated in the ε direction.

In FIGS. 7 to 9, two auxiliary arms 49, 49 are fixed to the tip of the arm 16 by screws 51. A rotary member 52 that constitutes the sheath holder 17 is provided between the auxiliary arms 49, 49 so as to be sandwiched therebetween. The rotating member 52 has a groove portion 53 provided at the tip of the auxiliary arms 49, 49.
It is held between the arm 16 and the arm 16 by a fixing screw 54 which is screwed into the rotating member 52.

A cylindrical holding cylinder 56 is rotatably inserted in the rotating member 52, and a holder main body 58 in which a sheath insertion portion 57 constituting the sheath 2 is inserted in the holding cylinder 56. Has been inserted.

A screw portion 59 is screwed on the front end portion of the holding cylinder 56, and the screw portion 59 can be screwed into a support member 61 constituting the support tool 18. A flange portion 62 is formed on the front end portion of the holder main body 58, and the flange portion 62 and the front end surface of the support member 61 sandwich the arm 14. A screw portion 63 is formed at the rear end portion of the holder main body 58, and the screw portion 63 presses the rear end surface of the holding cylinder 56 to clamp the arm 14 with the flange portion 62. A tightening nut 64 is screwed in so that Further, a threaded portion 67 having a small diameter and provided with a plurality of slits 66 in the axial direction is screwed behind the threaded portion 63.
A nut 68 is screwed into the screw 7, and the sheath insertion portion 57 is tightened and fixed.

The stepped portion 7 of the support body 69 is formed on the rear end surface of the support member 61.
1 abuts and is fixed by a fixing screw 72. On the rear end surface of the support body 69, two support shafts 73, 73
Is provided and penetrates the support body 69 and the support member 61. The support shafts 73, 73 are hollow, and caps 74 are screwed into both ends of the support shaft 73 so as to close the hollow portions.

As shown in FIGS. 1 to 3, the slide device 19 includes two support shafts 7 extending rearward from the rear end surface of the support body 69.
It is held by 3,73. This slide device 1
9 sandwiches the two support shafts 73, 73 between the slide body 76 and the fixed plate 77, penetrates the fixed plate 77,
It is fixed to the support shafts 73, 73 by a fixing screw 78 screwed into the slide body 76. This slide body 7
A convex portion 79 is formed on the upper surface of 6 in the axial direction of the sheath 2, and a support body 82 having a groove portion 81 slidably engaged with the convex portion 79 is provided. This support body 8
An adapter 4 is fixed to the upper surface of 2.

A rack 83 is provided on the upper surface of the convex portion 79 in the axial direction, and the pinion 8 provided in the support body 82 is provided.
It is designed to mesh with 4. Both ends of the pinion 84 project from the support body 82, and a knob 87 is fixed to the projecting end by a screw 86. By rotating this knob 87, the support main body 82
Can be moved in the axial direction.

A reference line 80 is provided on the side surface of the slide body 76, and a scale 85 is engraved on the side surface of the support body 82. The amount of movement of the support body 82 that is moved by rotating the knob 87. Is visible.

In FIG. 13, the adapter 4 includes a support body 82 and a holding plate 89 fixed to the support body 82 by fixing screws 88.
It is designed to be sandwiched by the
The adapter 4 can be fixed to the main body 82 by screwing. A fixing screw 90 is screwed into the lower surface of the slide body 76, and the tip of the fixing screw 90 abuts against the lower surface of the support body 82 and presses it so that the support body 82 can be fixed. Has become.

As shown in FIG. 14, the adapter 4 is fixed by placing the adapter 4 positioned on the upper part of the support body 82 in a half-circle around a holding belt 92 fixed to the support body 82 at one end by a fixing screw 91. The adapter 4 may be fixed by winding and locking the other end to the pin 93 provided on the support body 82.

In addition, as shown in FIG.
4, a pressing arm 96 is provided, and the adapter 4 is sandwiched between the support body 82 and the pressing arm 96.
Alternatively, the fixing claw 97 provided on the support member 6 may be fixed to the support body 82 by locking.

In FIG. 10, the telescope 3 includes a rigid and elongated insertion part 102, a large diameter operation 103 connected to the rear part of the insertion part 102, and a diagonally rearward branch from the side part of the operation part 103. The eyepiece portion 21 is provided and the treatment tool attachment portion 106 is provided at the rear end portion of the operation portion 103.

Although not shown, the eyepiece unit 104 may be vertically branched from the side of the operation unit 103, and may be vertically bent in the middle so that the eyepiece is substantially parallel to the operation unit 103.

The insertion section 102 is composed of a lens tube 107 and a light guide tube 108. The lens tube 107 passes through the inside of the operation section 103 and is inserted up to the vicinity of the portion where the eyepiece section 21 extends. There is.

The operation part 103 is provided on the operation part main body 105 having the eyepiece part 21 and the treatment instrument attachment part 106, and is provided slidably on the front end part of the operation part main body 105, and is fixed after being positioned. And a connecting member 109 as a part. The connecting member 109 is the insertion portion 10
The sheath 2 through which 2 is inserted is connected to the distal end portion.

An objective lens system 111 is provided in the lens tube 107, and the gradient index lens 1 is provided behind the objective lens system 111.
12 are provided. A light guide fiber 113 is inserted through the light guide tube 108. The light guide fiber 113 is adhesively fixed at the end portion of the light guide tube 108 on the objective side, and then the front end face 114 is polished to illuminate the illumination light. The light can be emitted from the surface 114. The light guide fiber 113 is inserted through the light guide tube 108, is bent sideways in the operation portion 103, and is bonded and fixed to the light guide ferrule 116 extending to the side portion of the operation portion 103, and then the end surface 117 is polished. It is supposed to be done. The end surface 117 serves as an entrance surface for illumination light supplied from a light source device (not shown).

A positioning member 118 is provided on the rear end side of the connection member 109.
Are fitted and fixed. The positioning member 118 is the gradient index lens 1 exposed from the lens tube 107.
A fixing hole 119 into which a rear end portion of the connecting member 12 is inserted is provided, and further, from the front end surface of the connecting member 109, the operation portion main body 10 is provided.
A channel tube 122 that penetrates the inside of the tube 5 in parallel with the lens tube 107 and forms a treatment instrument channel 121 that reaches the treatment instrument attachment portion 106 penetrates therethrough.

Gradient refractive index lens 11 inserted in the fixing hole 119
A lens 126 is provided on the rear end surface of the lens 2.

An eyepiece tube 129 is attached to the eyepiece section 21.
In this eyepiece tube 129, there is provided an eyepiece lens system frame 133 to which a triangular prism 131 and a trapezoidal prism 132 provided behind the lens 126 are attached so as to bend the optical axis of the observation optical system. . This eyepiece 129
At the rear end, an eyepiece exterior 134 is provided, and further,
An eyepiece 136 is provided at the rear end of the eyepiece exterior 134.

The treatment instrument attachment portion 106 is fitted to the rear end portion of the operation portion main body 105 and fixed by a screw 137.
38 and a detachable ring 139 at the rear end of the closing member 138.
And a treatment tool adapter 141 detachably attached by screwing.

The outer peripheral surface to which the closing member 138 is fitted is the operation portion main body 1
05 and an O-ring 142 keep airtightness, and further, a hole 143 into which the channel tube 122 is fitted is formed at the center. An O-ring 144 is provided in the hole 143 so as to maintain airtightness with the channel tube 122.

The treatment instrument adapter 141 is kept airtight by an O-ring 140 and is fitted and fixed to the closing member 138, and a treatment instrument insertion port 146 communicating with the treatment instrument channel 121 is provided on the rear end face thereof. 147 and a cock 148 that can open and close the treatment instrument insertion port 146. A lever 145 is provided on the upper part of the cock 148, and the cock 148 is provided on the lower part of the adapter body 1.
A nut 149 is screwed so as to be attached to 47.

In FIG. 16, the insertion portion 102 of the telescope 3 is shown.
Is inserted in the upper portion of the sheath insertion portion 57 fixed to the sheath holder 17. A large-diameter main body 151 is continuously provided at the rear end of the sheath insertion portion 57, and a connection member 109 provided at the front of the telescope 3 is further provided at the rear end of the main body 151. A connecting portion 152 is provided so that the tip of the can be detachably connected. The main body 151 is provided with a cock 153 to which the water supply tube 23 is connected.

In addition to the water supply port 25, a drainage port similar to the water supply port 25 may be provided so that the water can be discharged together with the water supply.

In the sheath insertion portion 57, the insertion portion 1 of the telescope 3
02, the probe 154 of the ultrasonic suction device 6 is inserted. The probe 154 is inserted through the treatment instrument channel 121, and the distal end portion of the probe 154 projects from the sheath insertion portion 57 so as to come into contact with the hematoma 156.

When inserting the sheath insertion portion 57 into the brain, the first
A mandolin 157 as shown in FIG. 7 is inserted into the sheath 2 and punctured. This mandolin 157
Is a tip portion 15 having a convex portion formed on the tip for easy puncture.
8, an elongated insertion portion 159 continuously provided behind the tip portion 158, a large-diameter connection portion 161 continuously provided at the rear end of the insertion portion 159, and a rear end surface of the connection portion 161. The connection portion 161 can be detachably connected to the connection portion 152 of the sheath 2.

As shown in FIGS. 11 and 12, the adapter 4 is connected to the rear end portion of the telescope 3 from which the treatment instrument attachment portion 106 is removed.

The adapter 4 includes an adapter body 163 and a slide member 164. Adapter body 163
Can be detachably connected to the operation unit 103 of the telescope 3 via the connection member 166 by the attachment / detachment ring 139.

At the front end of the connecting member 166, when the O-ring 167 for preventing leakage of the perfusate in the adapter 4 and the probe 154 are broken, the broken probe 154 is prevented from falling into the skull. It has an O-ring 168 that holds down the node of the vibration. A horn 169 of the ultrasonic suction device 6 is provided in the slide member 164, and a probe 154 that connects the inside of the adapter body 163 and the inside of the sheath insertion portion 57 is fastened to the tip of the horn 169 by a connecting portion 171. Has been done. The rear end of the slide member 164 is connected to the cover 172 of the ultrasonic suction device 6. An O-ring 173 is provided between the slide member 164 and the horn 169 to prevent the perfusate from flowing into the ultrasonic suction device 6. Adapter body 1 on outer peripheral surface of slide member 164
An O-ring 176 is provided in the portion inserted into the 63 to keep the adapter 4 watertight and prevent the perfusate from flowing out.

Cam grooves 177 are provided on the adapter body 163 in the circumferential direction and in the slide member 164 in a helical shape on the circumference, and are fixed to a rotatable cam ring 178 provided on the outer circumference of the adapter body 163. The cam pin 1
79 is engaged with the cam groove 177. Further, a groove 181 is provided on the outer periphery of the slide member 164 in the axial direction, and the tip end of a guide pin 182 screwed inward from the outer peripheral surface of the adapter body 163 is engaged with the groove 181. Has been done. By rotating the cam ring 178, the cam pin 179 is moved along the cam groove 177.
Is designed to slide. An adapter body 163,
Since the positional relationship in the circumferential direction with the slide member 164 is regulated by the guide pin 182, the cam pin 1
The slide member 164 can be moved in the axial direction of the adapter body 163 by the movement of 79 in the cam groove 177. Adapter body 1 of slide member 164.
The probe 154 can be moved in the axial direction with respect to the adapter body 163 along with the movement in the axial direction with respect to 63.

A reference line 18 is formed on the outer peripheral surface of the cam ring 178 in the axial direction.
3 is engraved and is fixed on the outer peripheral surface of the adapter main body 163 by a presser ring 184.
Scale 187 engraved on 86 and the reference line 183
From this position, the moving distance of the cam ring 178 in the axial direction with respect to the adapter body 163, that is, the amount of protrusion of the tip of the probe 154 can be known.

A fixing screw 188 is provided at the upper rear end of the outer circumference of the adapter body 163. By screwing the fixing screw 188, the tip of the fixing screw 188 presses the outer peripheral surface of the slide member 164, and the slide member 164 is attached to the adapter. Body 16
It can be fixed at a desired position with respect to 3, and
By loosening the fixing screw 188, the slide member 16
4 is slidable with respect to the adapter body 163.

FIG. 11 shows a state in which the slide member 164 is maximally extended. In this state, the tip end surface of the probe 154 is flush with the end surface of the sheath insertion portion 57 or slightly retracted. Further, FIG. 12 shows a state where the slide member 164 is contracted to the minimum, and in this state, the distal end surface of the probe 154 has the sheath insertion portion 57.
It is more prominent.

The operation of the brain surgery device 1 configured as above will be described.

Arm 14 of stereotaxic device 5 and arm 1 of fixation device 7.
The support main body 69 to which the support shafts 73 and 73 are fitted and fixed is brought into contact with the support member 61 which is fixed to the sheath holder 17 to which the sheath 2 is fixed in advance, and fixed by the fixing screw 72.

On the other hand, the support body 82 that constitutes the slide device 19 on the adapter 4 that connects the telescope 3 and the ultrasonic suction device 6
After fixing the support shafts 73, 73, the insertion portion 102 of the telescope 3 is inserted into the sheath insertion portion 57.
The slide device 19, the telescope 3, the adapter 4, and the ultrasonic suction device 6 into the sheath 2
The telescope 3 and the sheath 2 are securely fixed at a position where they are slid to the side and completely connected to the sheath 2, and the slide body 76 is fixed to the support shafts 73, 73 by a fixing screw 78.

Loosen the nut 68 of the sheath holder 17 and the sheath holder 1
The sheath insertion portion 57 is made movable with respect to 7, and the knob 87 of the slide body 76 is rotated. The knob 87 rotates the pinion 84 meshing with the rack 83 to rotate the sheath 2
The telescope 3, the adapter 4, and the support main body 82 are moved together in the sheath central axis direction with respect to the sheath holder 17, the support 18, the support shaft 73, the slide main body 76, and the like.

When fixing the sheath 2 at a desired position, a fixing screw 9
It can be fixed by screwing 0. After the slide device 19 is positioned as described above, the probe 154 inserted into the sheath insertion portion 57 is attached to the cam ring 17 by the probe 154.
By rotating 8 the needle 8 is projected from the sheath insertion portion 57, reaches the hematoma 156 under the observation of the telescope 3, and can be crushed and sucked.

In this embodiment, by rotating the knob 87, the sheath 2, the telescope 3, the adapter 4, and the ultrasonic suction device 6 can be integrally moved in the axial direction, so that the movement can be performed accurately and reliably. .

Further, the telescope 3, the adapter 4, and the ultrasonic suction device 6
Since hematoma can be sucked while moving and, the work efficiency can be improved and the operation time can be shortened.

Furthermore, since the position of the tip of the treatment tool is fixed to the position where the telescope 3 can see the field of view most easily and the surgery can be performed, it is not necessary to forcibly project the treatment tool and the safety is high.

Furthermore, since the scale 85 is provided on the slide body 76 and the support body 82, the amount of movement of the slide device 19 can be accurately grasped.

In this embodiment, the adapter 4 is fixed to the support body 82, but either the telescope 3 or the sheath 2 may fix the ultrasonic suction device 6 to the support body 82.

FIG. 19 is a structural explanatory view of a slide device according to the second embodiment of the present invention.

At the rear end of the support body 69, an elongated support shaft 191 that constitutes the slide device 19 is provided parallel to the axial direction of the sheath 2. A rack 192 is engraved on the support shaft 191, and a pinion 194 provided on a support body 193 meshes with the rack 192. The support body 193 includes a telescope 3 and an ultrasonic suction device 6
An adapter 4 for connecting and is fixed.

The pinion 194 is provided with a knob (not shown), and by rotating the knob, the sheath 2, the adapter 4, and the ultrasonic suction device 6 can be moved in the axial direction of the sheath 2. There is.

In this embodiment, since the components corresponding to the slide body 76 of the first embodiment are omitted, the structure of the slide device 19 can be simplified and the weight can be reduced.

Other configurations, operations and effects are similar to those of the first embodiment.

FIG. 20 is a structural explanatory view of a slide device according to the third embodiment of the present invention.

At the rear end of the support body 69, an elongated support shaft 196 forming the slide device 19 is provided parallel to the axial direction of the sheath 2. A support body 197 is provided on the upper surface of the support shaft 196.
Is provided slidably, and the support body 197 is a slot 1 provided in the axial direction of the sheath 2 of the support shaft 196.
It can be fixed to the support shaft 196 by a fixing screw 199 screwed through 98. The support body 197 fixes the adapter 4 that connects the sheath 2 and the ultrasonic suction device 6.

In this embodiment, the upper surface of the support shaft 196 is slid regardless of the moving method between the rack and the pinion, so that the configuration can be further simplified as compared with the second embodiment.
Can be lightened.

It should be noted that two support shafts 196 may be provided in a rod shape in parallel, and the fixing screw 199 may be inserted between the support shafts 196.

Other configurations, operations and effects are similar to those of the first embodiment.

Although the ultrasonic suction device is connected in each of the above-described embodiments, the present invention is not limited to this, and for example, a treatment tool such as a high-frequency electrode, a laser probe, forceps, or a syringe may be connected.

[Effects of the Invention] As described above, according to the present invention, positioning and holding of a surgical instrument can be performed accurately and reliably, and the position of the surgical instrument with respect to the patient's head can be adjusted with high accuracy.

[Brief description of drawings]

1 to 18 relate to a first embodiment of the present invention,
FIG. 1 is a sectional view of the slide device, and FIG. 2 is A- in FIG.
Sectional view in the A'direction, FIG. 3 is an external view of the slide device, and FIG.
FIG. 5 is a perspective view of the fixing device, FIG. 5 is a cross-sectional view of the fixing device, FIG. 6 is a cross-sectional view taken along the line BB ′ of FIG. 5, FIG. 7 is an explanatory view of the sheath holder, and FIG. 7 is a sectional view taken along the line CC ′ of FIG.
9 is a sectional view taken along the line DD ′ of FIG. 8, FIG. 10 is an explanatory view of the configuration of the telescope, FIG. 11 is an explanatory view of the configuration of the adapter, and FIG. 12 is the sliding state of FIG. Illustration,
13 is a sectional view of a supporting body, FIG. 14 is a sectional view of a supporting body fixed with a presser belt, FIG. 15 is a sectional view of a supporting body fixed with a pressing arm, FIG. 16 is a sectional view of a sheath,
FIG. 17 is an external view of a mandolin, FIG. 18 is an overall configuration diagram of a brain surgery device, FIG. 19 is an explanatory diagram of a configuration of a slide device according to a second embodiment of the present invention, and FIG. 20 is an illustration of the present invention. It is a structure explanatory view of the slide device concerning a 3rd example. 1 ... Brain surgery device 2 ... Sheath 3 ... Telescope 4 ... Adapter 5 ... Stereotactic brain surgery device 6 ... Ultrasonic suction device 7 ... Fixing device 18 ... Supporting device

Claims (1)

[Claims] 1. A brain surgery device comprising a stereotactic brain surgery device, a sheath, a telescope, and a treatment tool. A support device fixed to the stereotaxic brain surgery device and supporting at least the sheath, and at least the support device. A brain surgery device comprising: a slide device capable of moving the telescope forward and backward with respect to the insertion direction.