WO2016140386A1 - Dispositif de dissection de tissu - Google Patents

Dispositif de dissection de tissu Download PDF

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Publication number
WO2016140386A1
WO2016140386A1 PCT/KR2015/002136 KR2015002136W WO2016140386A1 WO 2016140386 A1 WO2016140386 A1 WO 2016140386A1 KR 2015002136 W KR2015002136 W KR 2015002136W WO 2016140386 A1 WO2016140386 A1 WO 2016140386A1
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WO
WIPO (PCT)
Prior art keywords
tube
tissue
peeling
ligation
connecting member
Prior art date
Application number
PCT/KR2015/002136
Other languages
English (en)
Korean (ko)
Inventor
윤치순
Original Assignee
윤치순
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 윤치순 filed Critical 윤치순
Priority to PCT/KR2015/002136 priority Critical patent/WO2016140386A1/fr
Publication of WO2016140386A1 publication Critical patent/WO2016140386A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets

Definitions

  • the present invention relates to a tissue detachment apparatus, and more particularly, to facilitate the detachment of tissues such as blood vessels, nerves, vas deferens and tubules to the surgeon through ultrasound-based imaging or endoscopy, without damaging the tissues. It relates to a tissue detachment device that allows for detachment from surrounding tissues.
  • tissue refers to a group of cells in which various types of cells gather to maintain a certain shape and perform a certain function. For example, blood vessels, nerves, vas deferens, fallopian tubes, bones, and adipose tissue Included.
  • tissue During surgery, certain tissues must be separated from the surrounding tissues to perform certain techniques. The separation of specific tissues from surrounding tissues is called dissect ion.
  • Ligation refers to the operation of binding the exfoliated tissue.
  • a process of enclosing the exfoliated tissue is performed by entering the ligation thread through the exfoliated space, and in order to easily and safely perform such exfoliation and ligation process, The process of widening the space between the tissue and the surrounding tissue should be involved.
  • a biological tissue peeler for the endoscope Its main technical configuration, as shown in Figure 1, to form a tip curved surface, inside the biological tissue.
  • a head portion 12 to be dug into the body a body 10 formed integrally with the head portion 12, the endoscope passing portion having an endoscope therein recessed therein, and having a guide rail;
  • a handle 20 coupled along the longitudinal direction of the main body 10 so that the force of the operator coincides with the direction of the peeling;
  • an adapter 30 assembled to the other end of the handle 20 and passing through the endoscope to the center.
  • the prior art is characterized in that it is configured to access the surgical equipment to the surgical site by opening the living tissue, but because the access to the surgical site is made only linearly, it is difficult to secure the field of view, the access to the tool for peeling is secondary Peeling of the surrounding tissue is required, and thus there is a problem that can damage the surrounding tissue.
  • the present invention has been made to solve the problem sleep of the prior art as described above, the object of the present invention is a tissue detachment device to facilitate the separation of tissues such as blood vessels during surgery through an ultrasound image or endoscope In providing.
  • the present invention to expand the space between the tissue to be peeled by using the pressure of the fluid and the surrounding tissue while at the same time to allow the separation between the tissue by the expansion member to expand by hydraulic pressure
  • Another object of the present invention is to provide a tissue detachment apparatus that allows the detachment operation to proceed more safely without damaging the tissue and surrounding tissue.
  • the present invention is to minimize the incision site of the skin necessary for the detachment of the tissue, and due to the multiple curved curves 6
  • the object of the present invention is by ultrasonic.
  • the present invention provides a tissue detachment apparatus that facilitates detachment of tissues such as blood vessels during surgery through an imaging or endoscope, and at the same time facilitates positioning of the silol for ligation.
  • the present invention is to minimize the incision site of the skin required for tissue exfoliation, and the external tissue and the tissue to be exfoliated in a point that is difficult to reach in a straight line due to the curved tube consisting of multiple than even without damage
  • Another object of the present invention is to provide a tissue detachment apparatus that can be easily peeled off and that the ligation thread can be easily located in the space where the peeling is performed.
  • the tissue peeling apparatus it is characterized in that it comprises a tube which is separated in multiple stages so that the length can be adjusted to the linear reciprocating movement, and a connecting member provided in the front end of the tube is connected to the separation tool.
  • the peeling tool is characterized in that the fluid injection pipe is injected through the tube and the connecting member to inject a fluid around the tissue to be peeled off.
  • the front end of the fluid injection pipe is characterized in that one or more injection holes formed.
  • the front end of the fluid injection pipe is characterized in that the needle (needle) is provided.
  • an outer side of the front end of the fluid injection pipe is characterized in that the expansion member is expanded and contracted in accordance with the supply of the fluid injected from the injection hole.
  • the front end of the connecting member is made of a curved surface
  • a through hole through which the fluid injection tube passes is formed in the center of the front end portion
  • the diameter of the coupling member is characterized in that it is formed larger than the diameter of the tube.
  • the tube is made of an elastic material.
  • the tube is characterized in that consisting of an arc shape.
  • the tube is characterized by consisting of a hollow first tube bent in an arc shape, and the second to n-th tube which is inserted into the first flow of the first sequential. (N is a natural number less than 3 and less than 7)
  • the tube is characterized in that the peeling pressure measuring device is connected to be installed to measure the pressure applied to the tube when the tube enters the human body.
  • the peeling pressure measuring device includes a housing coupled to an outer circumferential surface of a rear end of the tube, a coupling part inserted into an inner side of the housing, coupled to a rear end of the tube, and a spring fitted to an outer circumferential surface of the coupling part. Characterized in that configured.
  • the peeling pressure measuring device is characterized in that the load cell is installed in the tube.
  • the multi-stage separation in the tissue peeling device, is configured to be adjustable in length and the linear reciprocating movement of the tube, and provided in the front end of the tube inflated and contracted depending on whether the fluid supplied from the tube Characterized in that configured to include an expansion member.
  • the present invention for achieving the above objects,
  • the tissue peeling apparatus it is characterized in that it comprises a connection member which is provided in the front end of the tube and the tube for linear reciprocating movement is separated and configured in multiple stages to enable the length adjustment is connected to the ligation seal.
  • the tube is characterized in that made of an elastic material.
  • the tube is characterized in that it consists of an arc always.
  • the tube may include a first hollow tube bent in an arc shape, and second to nth tubes sequentially inserted into the first tube. (N is a natural number of 3 to 7)
  • the connecting member is screwed to the front end of the n-th tube, the inner The through-hole is formed through the ligation thread, the front end portion is characterized in that the fixing groove for fixing the ligation seal is formed. And, the front end portion of the mall ligation yarn is connected to the engaging ring is fitted into the fixing groove, the ligation thread is characterized in that both ends are thin and the middle portion is made thick.
  • the coupling groove is formed on one side of the first tube, the coupling groove is characterized in that the capture device for capturing the front end of the ligation seal is coupled.
  • the capture device is formed with a protrusion coupled to the wire is coupled to one end portion, the other end is formed with a locking portion is coupled to the capture groove, the central portion is inserted into the hook is connected to the front end of the ligation seal thread It is characterized in that the spring including the insertion portion, and the settled portion is placed through the engaging ring inserted through the insertion portion.
  • the tube is characterized in that the peeling pressure measuring device is connected is installed to measure the pressure applied to the tube when the tube enters the human body.
  • the peeling pressure measuring device is configured to include a housing coupled to the outer peripheral surface of the rear end of the tube, the coupling portion inserted into the inside of the housing coupled to the rear end of the rib and the spring fitted to the outer peripheral surface of the coupling portion It is characterized by.
  • the peeling pressure measuring device is characterized in that the load cell is installed in the rib.
  • the connecting member characterized in that it further comprises a yarn feeder for connecting the yarn.
  • the yarn transfer device is characterized in that it comprises a hollow body portion, and a head portion coupled to the front end of the body portion and the uniaxial end of the ligation seal is connected.
  • the front end of the body portion is formed with a fixing projection protruding
  • the head portion is characterized in that the fixing groove is formed is inserted into the fixing projection.
  • a space portion into which the head portion is inserted is provided inside the connection member. It is characterized in that the inlet side of the space portion is provided with a support spring for supporting the head portion inserted inward.
  • connection member is characterized in that the needle (Needle) shape.
  • the present invention has an excellent effect of allowing safe and easy detachment of tissues such as blood vessels during surgery through an ultrasound image or an endoscope. .
  • the present invention minimizes the incision site of the skin necessary for tissue detachment, and can easily detach the tissue even when the use of surgical tools is limited, such as during surgery through an image such as endoscope or ultrasound. Has an additional effect.
  • according to the present invention further has the effect of being able to peel off without damage even the external tissue located in the point difficult to reach in a straight line due to the multiple curved tube made of multiple and the target tissue.
  • FIG. 1 is a diagram showing a biological tissue exfoliator for a conventional endoscope.
  • 2 is a view showing an example of use of the tissue detachment apparatus according to the present invention.
  • Figure 3 is a view showing an embodiment of a tissue detachment apparatus according to the present invention.
  • Figure 4 is a view showing a state in which the fluid injection pipe is coupled to the present invention shown in FIG.
  • FIG. 5 is a view showing a needle combined with the present invention shown in FIG.
  • Figure 6 is a view showing a state in which the expansion member is coupled to the present invention shown in FIG.
  • Figure 7 (a) to (h) is a view showing a process of peeling the tissue using the present invention shown in FIG.
  • FIG. 8 is a view showing another embodiment of a tissue detachment apparatus according to the present invention.
  • 9 is a view showing a peeling pressure measuring device of the tissue peeling apparatus according to the present invention.
  • FIG. 10 shows another embodiment of a tissue detachment apparatus according to the present invention.
  • FIG. 11 is a view showing an embodiment of a tissue detachment apparatus according to the present invention. 12, (a), (b) and (c) are separate views of the present invention shown in FIG.
  • Fig. 13 is a view showing the ligation thread used in the tissue detachment apparatus according to the present invention.
  • FIG. 14 (a) to 14 (c) are views showing a development process of the present invention shown in FIG.
  • FIG. 15 is a view showing a capture device of the tissue detachment apparatus according to the present invention.
  • Figure 16 (a) ⁇ (e) is a view showing a recovery process of the tissue detachment apparatus according to the present invention.
  • FIG 17 shows another embodiment of a tissue detachment apparatus according to the present invention.
  • FIG. 18 is an exploded perspective view showing the yarn conveying apparatus of the present invention shown in FIG. 17;
  • FIG. 19 is a perspective view showing a state of the connecting member of the present invention shown in FIG.
  • 20 (a) to (c) is a view showing a state in which the ligation seal is connected to the connecting member of the present invention shown in FIG.
  • FIG. 21 (a) to (e) are views showing the peeling process using the present invention shown in FIG.
  • FIG. 2 is a view showing an example of use of the tissue detachment apparatus according to the present invention
  • Figure 3 is a view showing an embodiment of the tissue detachment apparatus according to the present invention
  • Figure 4 is a fluid spray pipe in the present invention shown in FIG.
  • FIG. 5 is a view showing a needle coupled to the present invention shown in Figure 4
  • Figure 6 is a view showing a state in which the expansion member is coupled to the present invention shown in Figure 4
  • 7 (a) to (h) is a view showing a process of peeling tissue using the present invention shown in Figure 6
  • Figure 8 is a view showing another embodiment of a tissue peeling apparatus according to the present invention
  • Figure 9 Figure 10 is a view showing a peeling pressure measuring apparatus of the tissue peeling apparatus according to the present invention
  • Figure 10 is a view showing another embodiment with a tissue peeling apparatus according to the present invention.
  • the present invention makes it possible to more easily exfoliate tissues 50 such as blood vessels, nerves, vas deferens, fallopian tubes, etc.
  • the tissues can be detached from surrounding tissues without damaging the tissues.
  • a tissue peeling device capable of ion the configuration is as shown in Figures 2 and 3, the hollow tube 100 is configured to be able to adjust the length greatly, and the flow of the rib 100 It comprises a connecting member 140 coupled to the front end.
  • the tube 100 is a guide diagram inserted to the periphery of the tissue 50 (hereinafter, the case where the tissue is 'vascular 50') to be peeled off after skin incision.
  • the detachment device easily reaches the periphery of the blood vessel 50 to be detached by being inserted into the sheath 60, which is a tube, or directly inserted into the human body to protrude out of the sheath 60 from the inside of the human body. It's a guide to help you.
  • the tube 100 when the tube 100 is formed in an arc shape, the tube 100 can be wrapped while separating the blood vessel 50 directly from the surrounding tissue, thereby peeling off without damaging the blood vessel 50 and the surrounding tissue. It can also play a role.
  • the rib 100 is made of a soft material having its own elasticity to facilitate access to the blood vessels 50 to be peeled off within the human body, is composed of multiple stages can be adjusted in length Desorption : ⁇ The device can be moved forward and backward more easily, and it can be easily reached without damaging the surrounding tissue even when the chocks or blood vessels 50 to be peeled are located deep inside the human body. .
  • the tube 100 may be configured in an arc shape, in this case, if the tube 100 is formed in an arc shape, the sheath 60 around the vessel 50 to be peeled off It protrudes outward and is configured to surround the blood vessel 50 to be peeled off while the length of the rib 100 changes.
  • the number of the tube 100 separated into multiple stages may vary depending on the purpose of use, for example, when used for peripheral nerve anesthesia, the number of tubes 100 is one or two When used for peeling of the tissue, it may be composed of three or more tubes (100).
  • the number of the tube 100 may be adjusted to three to seven, etc.
  • the tissue detachment apparatus according to the present invention.
  • the tube 100 as shown in Figures 2 and 8, the outermost first tube 110, the second tube 120 and the second flow tube 120 is inserted into the inner shaft is installed It comprises a third tube 130 is inserted into the installation of, the first tube 110, the second tube 120 and the third tube 130 are all made of a hollow shape, linear Consists of a tube having a straight or arc shape to enable reciprocating movement.
  • the first tube 110, the second tube 120 and the third tube 130 is a cylindrical tube having an arc shape having a circumferential angle of about 150 degrees Consisting out of the sheath 60 when the first tube 110 to the second tube 120 and the third tube 130 is sequentially projected to the periphery of the blood vessel to be peeled off when the protrusion is completed It is configured to wrap. At this time, it is a matter of course that the deployment order of the first to third flow grooves (110, 120, 130) can be reversed.
  • each of the ribs 110, 120, 130 is formed to have a circumferential angle of about 150 degrees.
  • the peeling between the blood vessel 50 and the surrounding tissue is naturally formed, and the peripheral circle of the blood vessel 50 to be peeled off by the shape of the arc 100 made of an arc shape. Because it approaches in a curved direction so that it can be wrapped, the blood vessel 50 and surrounding tissues are not damaged during the exfoliation process.
  • the tube 100 including the first tube 110, the second tube 120, and the third tube 130 has its own elasticity, the tube 100 can be easily inserted into the sheath 60. .
  • guide grooves are formed on inner surfaces of the first and second tubes 110 and 120, and second and third inserts are inserted into the first and second tubes 110 and 120.
  • the outer surface of the tube (120, 130) is formed so that the guide protrusion which is fitted into the guide groove is formed so that rotation does not occur during the deployment and recovery of the first to crab trifluid (110, 120, 130) Of course you can.
  • the connecting member 140 is to be provided at the front end of the tube 100, the separation tool such as fluid spray pipe 200, the ligation chamber 150 to be described later to be connected and supported It is to play a role.
  • the connecting member 140 as shown in Figure 3, the front end portion of the tube 100, preferably the n-th tube located in the innermost of the tube 100 is composed of a plurality of (in this embodiment It is formed integrally with the front end portion of the three tubes (130) or detachably coupled.
  • the front end portion of the connecting member 140 is configured to minimize the damage to the blood vessel 50 or the surrounding tissue during the exfoliation process using the tube 100 by forming a curved surface like the hemispherical shape.
  • the diameter (outer diameter) is larger than the diameter (inner diameter) of the first rib 110 so that when the tube 100 is recovered, the second tube 120 and the first tube 110 can be simultaneously recovered. It is. That is, since the diameter of the third tube 130 is smaller than the diameter of the second tube 120 or the first flow tube 110, when the tube 100 is recovered after peeling, only the third tube 130 is recovered and the first tube 130 is recovered.
  • the connecting member 140 can pull the second tube 120 and the first tube 110 together when the tube 100 is dilution. You can freely perform the development or recovery of.
  • the tissue peeling apparatus as shown in Figure 4, to be configured to further comprise a fluid injection pipe 200 as a peeling tool is installed connected to the connecting member 140.
  • the fluid injection pipe 200 serves to facilitate separation by spreading the gap between the tissues by the pressure of the fluid to be injected by injecting a fluid, such as air or water.
  • the biggest problem in the case of peeling tissue is that the tissue to be peeled and the surrounding tissue are so close that the surrounding tissue is damaged during the peeling.
  • the tissue to be peeled is the blood vessel 50
  • the blood vessel 50 the blood vessel 50
  • the connective tissue around the skin is characterized by a relatively smaller mechanical strength than the blood vessel 50.
  • Injecting a fluid between the blood vessel 50 and the connective tissue using this feature increases the pressure in the space into which the fluid is injected and causes the fluid to spread to the surroundings, and the fluid is spread to the relatively weak connective tissue.
  • the combined surrounding the blood vessel 50, the organization is' separated with a fluid between it is possible to easily and safely than the separation vessel (50).
  • a through hole 148 through which the fluid injection pipe 200 passes is formed at the center of the front end of the connection member 140, and at least one injection hole 210 is formed at the front end of the fluid injection pipe 200. It is formed so that the fluid supplied from the fluid supply means (not shown) is connected to the rear end of the fluid injection pipe 200 is configured to inject between the blood vessel 50 and the connective tissue, the fluid supply means is injected The pressure of the fluid may be adjusted to increase the space between the blood vessel 50 and the connective tissue by the pressure of the fluid.
  • the present invention can also be used for nerve block surgery such as regional nerve block.
  • the front end of the fluid injection pipe 200 or the connection member 140 to have a needle (needle) form to form the needle and the fluid injection pipe 200 or the connection member 140 integrally. It is also possible, of course, may be used in conjunction with the needle directly to the front end of the rib (100).
  • the expansion member 230 may be installed outside the front end of the fluid injection pipe 200, the plurality of injection holes 210 is formed, the expansion member 230 is a blood vessel (50) It is a function that makes it possible to safely expand the space between the network and the surrounding organization.
  • the expansion member 230 to expand by the fluid discharged from the injection hole 210 (mainly air is used) to the front end of the fluid injection pipe 200, damage to the surrounding tissue in the peeling process
  • the vessel 50 can be peeled safely without being added.
  • the expansion member 230 coupled to the outside of the front end of the fluid injection pipe 200 expands, the space between the blood vessel 50 and the surrounding tissue can be expanded.
  • the expansion member 230 is contracted again so that the connecting member 140 can be moved forward.
  • the fluid supply means enables forward and reverse control so that the supply of fluid as well as recovery is possible. It is configured to be possible.
  • the configuration of the fluid supply means for alternately generating the supply and recovery of the fluid by alternately controlling the stationary power is a technology that has been used in various fields, and is not intended to claim the present invention. Detailed description will be omitted.
  • the connecting member 140 provided at the front end of the tube 100 enters the widened space between the blood vessel 50 and the surrounding tissue through the outside of the expansion member 230.
  • the fluid injection pipe 200 is pushed back into the narrow space between the blood vessel 50 and the surrounding tissue, thereby expanding the expansion member 230.
  • the space between the blood vessel 50 and the surrounding tissue can be expanded, thereby allowing the vessel 50 to be detached more easily and safely. will be.
  • the tissue to be peeled off may be peeled from the surrounding tissues only by the above-described process, and as shown in FIG. 10, the tube 100 may be directly coupled to the front end of the tube 100 by expanding the expansion member 230.
  • the expansion member 230 may be configured to expand and contract by the fluid supplied and recovered.
  • the tube 100 may be connected to the peeling pressure measuring device 180 to measure the pressure applied to the tube 100 during the peeling process of the blood vessel 50, the peeling pressure measuring device ( 180 into the tube 100 human body
  • the peeling pressure measuring device 180 into the tube 100 human body
  • the pressure applied to the tube 100 is measured so that the operator can know, thereby preventing the tissue from being peeled off with excessive force. It will serve to prevent damage to the product.
  • the peeling pressure measuring device 180 includes a housing 182, a coupling part 184, and a spring 186, as shown in FIG. 9, wherein the housing 182 is disposed at an inner side thereof.
  • a space portion 185 into which the coupling portion 184 and the spring 186 are inserted is formed to serve to fix and support the coupling portion 184 and the spring 186 to obtain more accurate peeling pressure measurement results.
  • the coupling portion 184 is coupled to the rear end of the tube 100 to serve to transfer the pressure applied to the tube 100 in the peeling process, the spring 186 of the coupling portion 184 It is fitted to the rear outer circumferential surface and shrinks by the pressure generated during the peeling process, and serves to measure the peeling pressure by the degree of shrinkage.
  • the housing daewoo at the position where the spring 186 is inserted ( By forming a scale 187 to measure the contraction degree of the spring 186 on one side of the 182, it is possible to mechanically measure the peeling pressure without a separate sensor.
  • the housing 182 is made of a transparent material to visually check the degree of shrinkage of the spring 186.
  • a pressure sensor such as a load cell in the form of a film may be used as the peeling pressure measuring device 180.
  • the peeling process may be performed by installing the load sal inside the tube 100 or the fluid injection pipe 200.
  • the pressure applied to the tube 100 or the fluid injection pipe 200 may be configured to be confirmed through an electrical signal generated from the load sal.
  • the tissue detachment apparatus according to the present invention as described above, it is possible to safely and easily detach the tissue 50, such as blood vessels during surgery through an ultrasound image or endoscope, and at the same time the pressure of the fluid
  • the tissue and surroundings to be peeled off may be expanded to expand the space between the tissue to be peeled off and the surrounding tissue by using an expansion member that is expanded by hydraulic pressure.
  • the exfoliation work be performed more safely without damaging the tissue, but also minimizes the incision of the skin necessary for exfoliation of the tissue 50, and the curved tube made up of multiple external tissues and tissues to be exfoliated It has a variety of advantages, such as to be able to peel off without damage.
  • the tissue detachment apparatus will be described in detail a preferred embodiment of the tissue detachment apparatus according to the present invention.
  • FIG. 2 is a view showing an example of use of the tissue detachment apparatus according to the present invention
  • Figure 11 is a view showing an embodiment of the tissue detachment apparatus according to the present invention
  • Figures 12 (a), (b), (c 11 is a view showing the invention separately shown in Figure 11
  • Figure 13 is a view showing the ligation flesh used in the tissue detachment device according to the present invention
  • Figure 14 (a) ⁇ (c) is in Figure 11
  • Figure 15 is a view showing the development process of the present invention
  • Figure 15 is a view showing a capture device of the tissue detachment apparatus according to the present invention
  • Figures 16 (a) ⁇ (e) is a recovery process of the tissue detachment device according to the present invention a view showing, in Fig.
  • FIG. 9 is a view showing a separation pressure measurement device of the tissue separation device in accordance with the present invention
  • Figure 17 is a view showing another embodiment of the tissue separation device in accordance with the present, invention
  • Figure 18 is Figure 17
  • An exploded perspective view showing a seal feeder of the present invention shown 19 is a perspective view showing a state of the connecting member of the present invention shown in Figure 17,
  • Figure 20 (a) ⁇ (c) is a state in which the ligation seal is connected to the connecting member of the present invention shown in Figure 17 21 is a diagram illustrating a peeling process using the present invention shown in FIG.
  • the present invention makes it possible to more easily exfoliate tissues 50 such as blood vessels, nerves, vas deferens, fallopian tubes, etc.
  • the hollow tube 100 is configured to be largely adjustable, the front end of the tube 100 It comprises a connecting member 140 coupled to the part.
  • the tube (loo) is a tissue 50 to be peeled off after skin incision (hereinafter referred to as a case where the tissue is 'vascular 50') This will be described.
  • the tube 100 can be wrapped while separating the blood vessel 50 directly from the surrounding tissue, thereby peeling off without damaging the blood vessel 50 and the surrounding tissue. It can also play a role.
  • the tube 100 is made of a soft material having its own elasticity to facilitate access to the blood vessel 50 to be peeled from within the human body, and is composed of multiple stages to be configured to be adjustable in length to advance the peeling apparatus. And the reverse is more easily made, of course, even when the tissue or blood vessel 50 is to be located deep inside the human body is configured to be easily reached without damaging the surrounding tissues.
  • the tube 100 may be configured in an arc shape, when the tube 100 is formed in an arc shape in this way, the blood vessel to be peeled off It protrudes out of the sheath 60 in the periphery of 50, and is comprised so that the blood vessel 50 to peel may be peeled as the length of the tube 100 changes.
  • the number of the tubes 100 separated into multiple stages may vary depending on the purpose of use, for example, when used for peripheral nerve anesthesia, the number of tubes 100 is one or two. When used for peeling of the tissue, it may be composed of three or more ribs (100).
  • the number of the tube 100 may be adjusted to three to seven, etc.
  • the tube 100 is composed of three Embodiments of the tissue detachment apparatus according to the present invention.
  • the rib 100 has a first tube 110 positioned at the outermost side and a second tube 120 inserted into the inner side thereof. ) And the third tube 130 inserted into the second tube 120 and installed therein.
  • the first tube 110, the second tube 120 and the third tube 130 are all made of a hollow shape, with a straight or circular arc to enable linear reciprocating movement consist of.
  • the first flow tube 110, the second tube 120, and the third tube 130 may have a cylindrical shape having an arc shape having a circumferential angle of about 150 degrees. It is made of a bro, protrudes from the first tube 110 to the second tube 120 and the third tube 130 in the case of protruding out of the sheath 60 to wrap around the vessel to be peeled off when the protrusion is completed It is configured to be. At this time, it is a matter of course that the deployment order of the first to third tube (110,120,130) may be reversed.
  • each tube 100 is divided by 360 degrees constituting the circle by the number of tubes, and then the predetermined angle is added to secure the overlapping portions so that each tube 100 can support each other.
  • the peeling device is composed of three tubes (110, 120, 130) in total, about 30 degrees are supported by overlapping each other at 120 degrees divided by 360 degrees.
  • each tube 110, 120, 130 is formed to have a circumferential angle of about 150 degrees.
  • the separation between the blood vessel 50 and the surrounding tissue is naturally performed, and the periphery of the blood vessel 50 to be peeled off by the shape of the tube 100 having an arc shape.
  • Approach in a curved direction so that it can be wrapped in a circular shape will not cause damage to the blood vessel 50 and the surrounding tissue during the exfoliation process.
  • the rib 100 including the first tube 110, the second tube 120, and the third tube 130 has its own elasticity, it may be easily inserted into the sheath 60.
  • guide grooves are formed on inner surfaces of the first and second tubes 110 and 120, and are inserted into the first and second tubes 110 and 120.
  • Guide protrusions fitted into the guide grooves are formed to protrude on the outer surfaces of the second and third tubes 120 and 130 so that rotation is not generated during the deployment and withdrawal of the first to third tubes 110 and 120 and 130.
  • the connecting member 140 is to be provided at the front end of the tube 100, the tool such as the ligation chamber 150 to be described later to be connected to the tool installed so that the ligation chamber 150 is peeled off It is to position in space.
  • the front end portion of the third flow groove 130 is integrally formed or coupled to be detachable.
  • the front end portion of the connecting member 140 is configured such that its shape is curved like a hemispherical shape so as not to damage the surrounding tissue in the process of entering into the human body,
  • the diameter (outer diameter) is formed to be larger than the diameter (inner diameter) of the tube 100, and when the tube 100 is recovered, the connecting member 140 is configured so as to sequentially recover the tube 100 which is divided into a plurality of pieces. .
  • the connecting member 140 provided at the front end of the tube 100, the ligation chamber 150 may be peeled off the tissue by the ligation chamber 150 in the process of recovering the tube 100. At the same time as fixing the and serves to make it easy to recover the tube 100 after the peeling process is completed.
  • the connection member 140 is detachably coupled to the front end of the third tube 130 (the n-th groove) and provided through the tube 100.
  • the ligation seal 150 to be fixed is configured to be captured by the capture device 170 to be described later, the lower end of the connecting member 140, the front end of the third tube 130 is inserted and coupled to the inner peripheral surface
  • a coupling hole (not shown) having a female screw formed therein is formed, and a male screw 132 is formed on the outer side of the front end portion of the third tube 130 to connect the female screw to connect the connecting member 140 to the third tube 130. It is configured to be screwed to the front end of the.
  • the connecting member 140 is formed so that the front portion has a circular or oval shape to minimize damage to the blood vessel 50 or the surrounding tissue during the exfoliation process using the tube 100, the diameter
  • the second tube 120 and the first tube 110 may be simultaneously recovered. That is, since the diameter of the third tube 130 is smaller than the diameter of the second tube 120 or the first tube 110, when the tube 100 is recovered after peeling, only the third tube 130 is recovered and the first tube 130 is recovered.
  • the connecting member 140 can pull the shop 2 tube 120 and the first tube 110 together, so that the tube 100 in the peeling process can be recovered. It will be possible to freely deploy or retrieve.
  • connection member 140 a through hole (not shown) through which the ligation seal 150 supplied through the tube 100 is formed inside the connection member 140, and a through hole is formed at the front end of the connection member 140.
  • a fixing groove 142 is formed to fix the ligation seal 150 exited to the front end of the connecting member 140 through the fixing groove 142. 160 is fitted.
  • a ring-shaped locking ring 160 is connected to the front end of the ligation thread 150, and the locking ring 160 is used for ligation thread 150 using a capture device 170 to be described later.
  • the capturing operation of) is to serve easily.
  • the lower portion of the engaging ring 160 is formed with a coupling portion 162 is connected to the ligature seal 150 is protruding, the engaging ring 160 is fixed to the fixing groove 142 of the connecting member 140 It is fitted so that the engaging ring 160 does not rotate in the peeling process.
  • both ends are thinner and the middle portion may be formed in a thick form, the reason is that both ends of the ligation seal 150 by thinning the connection member ( When the thread is inserted through the through-hole formed in the 140, and when the thread is removed through the sheath 60, it is easier, and the middle portion of the ligation seal 150 is thickened by the peeling process or after peeling. This is to prevent damage to the blood vessel 150 by the ligation chamber 150 in the ligation process is made.
  • the ligation seal 150 is formed to be too thin. Blood vessel 50 may be damaged by seal 150 Since the middle portion of the ligation seal 150 is thickened, and both ends of the ligation seal 150 passing through the tube 100 are made thin and elastic, the ligation seal 150 is more easily formed. Will be able to come out through the tube (100).
  • the connecting member 140 may be coupled to the needle (needle) for the injection of drugs such as anesthetic instead of the ligation seal 150, which is the third tube 130 when performing anesthesia of the peripheral nerve under ultrasonic guidance
  • drugs such as anesthetic
  • connection member 140 may be formed integrally to form a needle (Needle) of course.
  • the first tube 110 is coupled to the capturing device 170 for capturing the hook ring 160 to which the ligation seal 150 or the ligation seal 150 is coupled after the peeling process.
  • Coupling groove 112 may be formed, the capture device 170 is inserted through the sheath 60 is fitted into the coupling groove 112 formed on one side of the first tube 110, the peeling is completed state Capturing the front end portion of the ligation chamber 150 in.
  • the capture device 170 includes a coupling part 172, a locking part 174, an insertion part 176, and a settlement part 178.
  • the portion 172 protrudes at one end of the capture device 170. Is formed is a wire 172a is coupled to allow the capture device 170 to enter and exit through the interior of the sheath 60, the engaging portion 174 is formed at the other end of the capture device 170 is the first By inserting into the coupling groove 112 formed in the tube 110 is to serve to fix the capture device 170 inserted through the sheath 60 to the first tube (110).
  • the insertion portion 176 is formed in the central portion of the capture device 170 to serve to allow the engaging ring 160 is connected to the front end of the ligation seal 150 can be inserted and coupled, the inner side Consists of a curved shape and the center portion is incised so that both sides are in contact with each other.
  • the inserting portion 176 is normally closed and then opened by the force that the catching ring 160 enters so that the catching ring 160 is captured by the capture device ( 170 is inserted into the inside and the insertion of the locking ring 160 is completed by the elasticity of the insertion portion 176 is returned to its original state by closing and closed, so that the completed insertion hook 160 can not escape again.
  • the locking ring 160 is inserted into the ' fixing groove 142 formed at the front end of the connecting member 140 and fixed to prevent rotation, so that the insertion unit 176 perpendicular to the capture device 170. Entering toward) may be easily inserted into the capture device 170.
  • the hook ring 160 inserted into the capture device 170 is inserted into the coupling groove 112 formed in the first tube 110, so that the ligation seal 150 may be taken out of the body. In the process is configured to pull out the hook 160 coupled with the ligation chamber 150 through a small cross-sectional area.
  • the settled portion 178 is formed on both sides of the insertion portion 176 made of an inwardly curved shape so as to allow the engaging ring 160 inserted and coupled through the insertion portion 176 can be placed.
  • the engaging ring 160 inserted and coupled into the capture device 170 through the insertion portion ⁇ 76 is placed in the settled portion ⁇ 78 protruding to the outer axis located on both sides of the insertion portion 176
  • the combined state is maintained, and the capturing operation of the catching ring 160 to which the ligation seal 150 is coupled is completed through the above process.
  • the catching device 160 to which the catching ring 160 is coupled is pulled out through the sheath 60, At this time, as shown in (a) of FIG. 16, when the wire 172a connected to the coupling portion 172 of the capture device 170 is pulled out, the capture device 170 is pulled out through the sheath 60 to the outside. As a result, as shown in FIG. 20 (b), the catching ring 160 coupled to the capturing device 170 and the ligation seal 150 coupled to the catching ring 160 can also be pulled out. do.
  • the tube 100 may be connected to the peeling pressure measuring device 180 to measure the pressure applied to the connecting member 140 and the rib 100 during the peeling process of the blood vessel 50,
  • the peeling pressure measuring apparatus 180 measures the pressure applied to the connecting member 140 and the tube 100 when the tube 100 enters the human body to peel the blood vessel 50 from the surrounding tissue, thereby allowing the operator to know.
  • connection member 140 when the connection member 140 enters the human body or tissue during the peeling process, the pressure applied to the connection member 140 and the tube 100 may be measured by resisting the entry motion.
  • the peeling pressure measuring device 180 includes a housing 182, a coupling part 184, and a spring 186, as shown in FIG. 9, wherein the housing 182 is disposed at an inner side thereof.
  • a space portion 185 into which the coupling portion 184 and the spring 186 are inserted is formed to serve to fix and support the coupling portion 184 and the spring 186 to obtain more accurate peeling pressure measurement results.
  • the coupling portion 184 is coupled to the rear end of the tube 100 to transfer the pressure applied to the connecting member 140 and the tube 100 in the peeling process
  • the spring 186 is fitted to the rear outer circumferential surface of the coupling portion 184 and contracts by the pressure generated in the peeling process to serve to measure the peeling pressure by the degree of shrinkage.
  • the step 185a is formed in the space 185 formed inside the housing 182 so that the spring 186 is supported, and the housing daewoo at the position where the spring 186 is inserted (
  • the housing 182 is made of a transparent material to visually check the degree of shrinkage of the spring 186.
  • the pressure sensor such as a load sal in the form of a film may be used as the peel pressure measuring device 180.
  • the load sal is installed inside the tube 100 to connect the connecting member ( 140 may be configured to check the pressure applied to the tube 100 through an electrical signal generated from the load cell.
  • tissue detachment apparatus may be configured to further include a thread feeder 190, the thread feeder 190 is the front end of the lambu 100 It serves to connect the ligation seal 150 to the connection member 140 coupled to the portion.
  • the yarn feeder 190 includes a body portion 192 and a head portion 194.
  • the body portion 192 is formed of a sheath 60. It is inserted into the inside to serve to connect the head portion 194 to the tube 100, that is, the connecting member 140 connected to the front end of the third tube 130, the ligation for the inside
  • the seal 150 is made of a hollow tube shape to pass through.
  • the head portion 194 is coupled to the front end portion of the body portion 192 is inserted into the coupling member 140 to serve to connect the ligation seal 150 to the connection member 140.
  • the head part (194) for ligation One end of the chamber 150 is connected.
  • the thread transfer device 190 is connected to the front end of the tube 13 in the state in which the first to third tube (110, 120, 130) wrapped around the blood vessel 50 to be peeled off It serves to connect the ligation seal 150 to the 140, when the operator inserts the body portion 192 into the inner side of the first tube 110 through the sheath 60, of the body portion 192
  • the head portion 194 connected to the front end portion is inserted into and coupled to the inner side of the connecting member 140 in the state of being inserted into the coupling groove 112 of the first tube 110 to connect the ligation seal 150 to the connecting member 140. Will be able to connect to
  • the front end of the body portion 192 is formed with a fixing projection (192a) protruding
  • the rear end of the head portion 194 is formed with a fixing groove (194a) is inserted into the fixing projection (192a) fixed head
  • the body portion 192 and the head portion (192) in the process of entering the yarn feeder 190 through the sheath 60 and the first flow 110 by holding the portion 194 is fixed to the front end of the body portion 192 ( 194 is configured to prevent separation.
  • the connecting member 140 is provided at the front end of the third flow 130, as shown in Figure 19, the space portion 144 into which the head portion 194 of the yarn feeder 190 is inserted And a support spring 146 for capturing the head portion 194 of the yarn transfer device 190, wherein the space portion 144 is formed to be positioned outside the third tube 130.
  • a through hole may be formed at the front end of the connecting member 140 to allow the other auxiliary peeling mechanism to pass therethrough, and the connecting member 140 in the above-described embodiment.
  • a separate connection device for capturing the head portion 194 of the thread transfer device 190 to).
  • the connecting member 140 of another embodiment of the tissue detachment apparatus may be formed integrally with the front end of the third tube 130, the first to third for the separation of the blood vessel 50
  • the third connection member 140 formed at the front end of the third tube 130 may be inserted into the coupling groove 112 formed in the first tube 110. It protrudes outward from the rib 130.
  • the pair of openings in the space portion 144 of the connecting member 140 A support spring 146 is installed, and the support spring 146 serves to support the head portion 194 inserted into the space 144 so as not to escape.
  • the support spring 146 is installed at the inlet of the space portion 144 of the connecting member 140 to be spaced apart from each other by a predetermined distance, the pair is installed, the center portion is cut off, that is, the space portion 144
  • the head portion 194 of the thread transfer device 190 is easily inserted into the space portion 144 of the connecting member 140, while the space portion is easily formed.
  • the head portion 194 inserted into the 144 is configured to not be pulled out.
  • the first to third tubes (110, 120, 130) are formed in an arc shape by developing the first to third tubes (110, 120, 130) in a state where the tube (100) is inserted into the sheath (60). 10, 120, 130 to wrap around the blood vessel 50 to be peeled off.
  • the connecting member 140 formed at the front end of the third tube 130 may be connected to the coupling groove 112 formed at the first rib 110. It is inserted inward.
  • the thread feeder 190 is pushed into the first tube 110 through the sheath 60 so that the head portion 194 is a space of the connecting member 140.
  • the head 192 is pulled out of the sheath 60 by the support spring 146 provided at the inlet of the space 144 of the connecting member 140.
  • the fixing protrusion 192a formed in the body portion 192 is supported and separated from the fixing groove 194a of the head portion 194 as shown in FIG. 21B, the head portion 194 is supported. Only the body portion 192 is released through the sheath 60 while remaining in the space portion 144 of the connecting member 140, and the ligation seal 150 installed at the head portion 194 is connected to the connecting member 140. ) Will be connected.
  • the third flow 130 and the second tube 120 and The l-th tube (no) is sequentially collected so that the ligation seal (150) connected to the connecting member (wo) surrounds the blood vessel (50) to be peeled off. At this time, it protrudes outward from the third tube (130). Since the formed connecting member 140 may pull the second tube 120 and the first tube 110 together and recover the same, the recovery of the tube 100 may be freely performed during the peeling process.
  • the tissue (50) while making it possible to safely and easily detach the tissue 50, such as blood vessels during surgery through an ultrasound image or an endoscope. Minimizing the incision site of the skin required for exfoliation, and because of the multiple curved shape of the rib 100, it is possible to exfoliate external tissues and tissues to be exfoliated without damage. .
  • the above embodiments have been described with reference to the most preferred examples of the present invention, but are not limited to the above embodiments.
  • the present invention relates to a tissue detachment apparatus, and more particularly, to make it possible to more easily detach the tissue of blood vessels, nerves, vas deferens, fallopian tubes at the time of surgery by means of ultrasound imaging or endoscopy without damaging the tissue. It relates to a tissue detachment device that allows for detachment from surrounding tissues. [Explanation of code]
  • Thread Feeder 192 Body

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Abstract

La présente invention concerne un dispositif de dissection de tissu et, plus particulièrement, un dispositif de dissection de tissu conçu de telle sorte que, au cours d'une opération sur base d'images ultrasonores ou d'endoscopes, des tissus tels qu'un vaisseau sanguin, un nerf, un canal déférent, d'une trompe de Fallope, etc. peut non seulement être disséqué plus facilement, mais peut également être disséqué de tissus environnants sans endommager les tissus. La présente invention concerne un dispositif de dissection de tissu caractérisé en ce qu'il comprend : un tube, qui comprend de multiples étages séparés, de telle sorte que la longueur correspondante peut être ajustée, et qui effectue un mouvement de va-et-vient linéaire ; et un élément de raccordement, qui est situé sur l'extrémité avant du tube et sur lequel est relié et installé un outil de dissection. La présente invention concerne un dispositif de dissection de tissu caractérisé en ce qu'il comprend : un tube, qui comprend de multiples étages séparés, de telle sorte que la longueur correspondante peut être ajustée, et qui effectue un mouvement de va-et-vient linéaire ; et un élément de raccordement, qui est situé sur l'extrémité avant du tube et auquel est relié un fil de ligature.
PCT/KR2015/002136 2015-03-05 2015-03-05 Dispositif de dissection de tissu WO2016140386A1 (fr)

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Application Number Priority Date Filing Date Title
PCT/KR2015/002136 WO2016140386A1 (fr) 2015-03-05 2015-03-05 Dispositif de dissection de tissu

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Application Number Priority Date Filing Date Title
PCT/KR2015/002136 WO2016140386A1 (fr) 2015-03-05 2015-03-05 Dispositif de dissection de tissu

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WO2016140386A1 true WO2016140386A1 (fr) 2016-09-09

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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5336231A (en) * 1992-05-01 1994-08-09 Adair Edwin Lloyd Parallel channel fixation, repair and ligation suture device
JPH09502120A (ja) * 1995-02-07 1997-03-04 シー・アール・バード，インコーポレイテッド 入れ子式弾性バンド連続結紮装置
KR19990009003A (ko) * 1997-07-07 1999-02-05 이길환 표피 박리기
US6974422B1 (en) * 1999-11-06 2005-12-13 Millar Instruments, Inc. Catheter pressure transducer with pressure sensing module
US7566318B2 (en) * 2003-04-11 2009-07-28 Cardiac Pacemakers, Inc. Ultrasonic subcutaneous dissection tool incorporating fluid delivery

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5336231A (en) * 1992-05-01 1994-08-09 Adair Edwin Lloyd Parallel channel fixation, repair and ligation suture device
JPH09502120A (ja) * 1995-02-07 1997-03-04 シー・アール・バード，インコーポレイテッド 入れ子式弾性バンド連続結紮装置
KR19990009003A (ko) * 1997-07-07 1999-02-05 이길환 표피 박리기
US6974422B1 (en) * 1999-11-06 2005-12-13 Millar Instruments, Inc. Catheter pressure transducer with pressure sensing module
US7566318B2 (en) * 2003-04-11 2009-07-28 Cardiac Pacemakers, Inc. Ultrasonic subcutaneous dissection tool incorporating fluid delivery

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