RU204620U1 - DEVICE FOR PROTECTING DURAL SACKS AND SPINAL NERVE DURING INTERVERTICAL DISC RESECTION - Google Patents

Abstract

The technical solution relates to medical equipment, surgical instruments used in traumatology, orthopedics and neurosurgery. The device provides a reduction in the risk of damage to the dural sac, spinal nerve, from accidental injuries. The device for protecting the dural sac and the spinal nerve during the resection of the intervertebral disc contains two articulated levers, at the ends equipped with handles and a working part in the form of flat sponges. The working ends of the levers are inclined to the plane of rotation of the levers. The plane of the jaws parting is perpendicular to the plane of rotation of the levers. The levers are equipped with a locking mechanism in the form of a ratchet. The ends of the jaws are rounded and bent in opposite directions, perpendicular to the jaw parting plane. 3 C.p. f-ly, 5 dwg

Description

The field of technology.

The technical solution relates to medical equipment, a surgical instrument used in traumatology, orthopedics and neurosurgery, the device is designed to protect the dural complex and the spinal nerve from damage during resection of the intervertebral disc, freeing the hands of an assistant surgeon, especially when performing minimally invasive surgical interventions.

State of the art.

In medicine, a repulsive surgical instrument with a working part in the form of a scapula or sponges, connected by means of hinges, is known to expand wounds, cavities, passages and to push back organs that are not subject to surgery in order to protect them from accidental injuries.

Known lever surgical instrument for tissue cultivation, which contains articulated levers, the counter movement of which is carried out by means of a hinge, with working ends in the form of sponges and handles equipped with a ratchet lock or flat spring to fix the position.

For example, a universal device for tissue dilution is known (source [1]: patent RU 2172143). The device contains pivotally connected branches with collet clamps and handles. Removable working jaws are fixed in collet clamps. Each working jaw is an L-shaped rod with a concave surface along the entire length of the jaw in the plane of the split. The device has a set of jaws of various heights, lengths and diameters of the working hole for tools. The jaws of the device are equipped with a screw unit for dilution and closure, which is kinematically connected to the handles.

The device [1] is intended for the implementation of osteosynthesis and is not suitable for protecting the dural complex and the spinal nerve during the resection of the intervertebral disc.

Known surgical instrument - a spatula for operations on intervertebral discs, containing sponges on the branch and the handle. (Source [2]: guide to emergency neurosurgery / VV Lebedev, LD).

The disadvantages of this tool [2] is the inconvenience of use due to the employment of both hands of the surgeon-assistant, the closure of the surgeon's view.

Known retractor (source [3]: RU 65369), containing hinged jaws, at the working ends of which are mirrors, the jaws are equipped with a mechanism for their dilution, made in the form of a spring.

The retractor [3], due to the shape of the working part, is not suitable for protecting the neural structures of the spine, abduction of the spinal nerve, when using a device for resecting the intervertebral disc. The handles do not detach, the view of the operating field is closed, the use of the help of the assistant surgeon's hands is required.

Known retractor (source [4]: RU 33304), containing two pivotally connected levers equipped with a mechanism for information and dilution, with handles, the working ends of which are inclined at an obtuse angle and equipped with flat jaws, when the handles of the levers are brought together, the jaws converge, the plane of the jaw connector is perpendicular the plane of rotation of the levers. The breeding mechanism is equipped with a locking mechanism in the form of a ratchet, and the working ends of the jaws in the form of flat jaws are installed parallel to each other.

However, the use of the known tool [4] for performing spinal surgeries is limited by a number of disadvantages: the working ends of the levers do not have the required geometric shape suitable for abducting the spinal nerve and protecting the dural complex, which does not allow for safe and accurate removal of tissues and protect them from injury during surgical manipulations, the handles do not have a free connection that allows easy removal and installation on the levers, levers without handles are not capable of fixing the position, as a result, ease of use is not ensured, the view of the operating field is closed, the use of the hands of an assistant surgeon is required.

The essence of the technical solution.

The technical task is to protect the dural complex and the spinal nerve during resection of the intervertebral disc, without significantly limiting the view of the operating field, reducing the risk of damage to the dural complex, the spinal nerve, relieving the hands of the assistant surgeon from accidental injuries.

The technical result is achieved by the fact that a device for protecting the dural sac and the spinal nerve during resection of the intervertebral disc, containing two articulated levers, at the ends equipped with handles and a working part in the form of flat jaws, the working ends of the levers are inclined to the plane of rotation of the levers, the plane of the jaw joint is perpendicular to the plane of rotation of the levers, the levers are equipped with a locking mechanism in the form of a rack. It differs in that the ends of the jaws are made rounded and bent in opposite directions, perpendicular to the plane of the jaw parting.

The combination of essential features of the claimed device provides the technical result - a decrease in the risk of damage to the dural sac, spinal nerve, from accidental injuries.

Another technical result is the expansion of the arsenal of technical means to protect the dural complex and the spinal nerve during the resection of the intervertebral disc.

The invention is illustrated by graphic materials:

Fig. 1 is a general view of the device;

Fig. 2 is a top view of the device, the jaws are brought together;

Fig. 3 is a top view of the device, the jaws are divorced;

Fig. 4 is a general view of the device, one handle is removed;

Fig. 5 - device, general view of the working part, the handles are removed.

Specification:

1- lever;

2- lever;

3- axis of rotation;

4- handle;

5- sponges;

6- working ends;

7- bend;

8- parting plane (jaw mating plane);

9- rack;

10-button lock;

11- branch.

Implementation of the device.

The device for protecting the dural complex and the spinal nerve during the resection of the intervertebral disc is a lever surgical instrument for diluting and protecting the tissues of the dural complex and the spinal nerve during spinal operations.

The device contains two levers 1 and 2, pivotally connected by an axis of rotation 3. The axis of rotation 3 provides the possibility of counter movement of the levers 1 and 2 in the same plane. Each of the levers 1 and 2 at the ends contains a handle 4 and a working part in the form of flat jaws 5. The working part is made so that when the handles 4 of the levers 1 and 2 are brought together, the jaws 5 diverge, when the handles 4 of the levers 1 and 2 are pulled together, the jaws 5 converge. The working ends 6 of the levers 1 and 2 are inclined to the plane of rotation of the levers 1 and 2 at an angle, it is provided that this angle is 45 degrees, but it is obvious that this angle can be changed and be, for example, 90 degrees or 50 degrees. The meaning of the bending of the working ends 6 and their inclination is to bring the plane of rotation of the handles 4 beyond the area where the working ends 6 of the levers 1 and 2 are located, since the jaws 5 are intended to be immersed in the operating wound to a certain depth. The working ends 6 have a curved geometric shape, the ends of the jaws 5 are rounded and bent in opposite directions, the folds 7 are located perpendicular to the plane of the connector 8 of the jaws 5 and at an angle to the plane of rotation of the levers 1 and 2. The plane of the connector 8 of the jaws 5 is perpendicular to the plane of rotation of the levers 1 and 2. Levers 1 and 2 are equipped with a mechanism for fixing the position, a ratchet lock, on one of the levers a ratchet 9 is installed, on the other there is a contact pad for contact of teeth. Kremaliera 9 is located on the branches outside the handles 4. Handles 4 are removable, for this handles 4 can be connected to levers 1 and 2 by a quick-release connection with a spring-loaded button lock 10, or handles 4 can be connected to levers 1 and 2 by a threaded connection.

The handles 4 at the junction with the branches can be provided with annular grooves with rubber seals placed in them and an orienting pin that goes into the corresponding orienting groove, outside of which there is a spring-loaded button - a lock that goes into the recess. When you press the spring-loaded button - the latch 10, handle 4 is released, and it is easy to remove it from the jaw 11.

Sponges 5 with bends 7, with the help of which the protection and safe removal of the dural complex and the spinal nerve during the resection of the intervertebral disc are carried out, can be additionally made with grooved surfaces and with rounded edges.

The device works as follows.

The device is proposed to be used in orthopedic and neurosurgical departments of medical institutions when performing an intervertebral disc resection operation.

After the patient is injected into anesthesia, an incision of the skin, subcutaneous tissue, paravertebral muscles, the arches, articular and transverse processes of the vertebrae are skeletonized. The arch is removed and the articular process, part of the yellow ligament, is resected. The intervertebral disc, dural sac, and spinal nerve are exposed. The working ends 6 of the device are immersed in the wound, the handles 4 remain outside. Sponges 5 are placed between the spinal nerve and the dural complex above the intervertebral disc, levers 1 and 2 are brought together by handles 4, the levers are turned on axis 3, sponges 5 with bends 7 capture and move the spinal nerve away from the pedicle of the arch. The ratchet 9 fix the achieved position of the levers 1 and 2. The handles 4 are removed from the jaws 11, freeing up the operating field and providing a better view of the wound and the possibility of performing surgical manipulations. Disc resection is performed. Flat jaws 5 with bends protect the dural sac and the spinal nerve from accidental unintentional damage during manipulations. The use of the proposed device reduces the time of surgical intervention and reduces the risk of damage to the neural structures of the spine, especially during resection of the intervertebral disc.

The divergence of the jaws 5 with the oncoming movement of the handles 4 allows the spinal nerve to be retracted, and at the same time the branches 11, located above the operating wound, are in a reduced position, fixed by the ratchet 9, which allows you to save more free space and improve visibility. Flat rounded jaws 5 with a bend to the plane of rotation of the handles 4, with bends 7 allow safe removal of soft tissues in the wound. The cremaliera 9 is located on the branches 11 outside the handles 4, and the handles 4 are removable, which allows for better visibility and free the surgeon's hands. The use of the button - latch 10 allows, when pressing the spring-loaded button - the latch 10, to release the handle 4 and remove it from the jaw 11. When using the threaded connection of the handles 4 with the jaws 11, the handles are screwed from the jaws 11 to free up space.

The device can be freely manufactured according to the state of the art from stainless alloy steel used in medicine, or titanium alloys, using technical means known for manufacturers of medical instruments.

Claims (4)

1. A device for protecting the dural sac and spinal nerve during resection of the intervertebral disc, containing two pivotally connected levers, at the ends equipped with handles and a working part in the form of flat jaws, the working ends of the levers are inclined to the plane of rotation of the levers, the plane of the jaw joint is perpendicular to the plane of rotation , the levers are equipped with a locking mechanism in the form of a ratchet, characterized in that the ends of the jaws are rounded and bent in opposite directions, perpendicular to the plane of the jaw part. 2. The device according to claim 1, characterized in that the handles are removable, the ratchet is located on the branches outside the handles, the handles are connected to the levers by a detachable connection with a spring button lock. 3. The device according to claim 1, characterized in that the handles are connected to the levers by a threaded connection, the working part is made so that when the handles of the levers are brought together, the jaws diverge. 4. The device according to claim 1, characterized in that the working ends of the levers are inclined to the plane of rotation of the levers at an angle of 45 degrees.

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