WO2018049779A1

WO2018049779A1 - Expander

Info

Publication number: WO2018049779A1
Application number: PCT/CN2017/072303
Authority: WO
Inventors: 萧慕东
Original assignee: 奥斯奥鹏外科产品股份公司
Priority date: 2016-09-19
Filing date: 2017-01-24
Publication date: 2018-03-22
Also published as: CN107837102A

Abstract

An expander comprises: a fixing means (1) having a channel allowing a lens barrel (8) of a lumbar microendoscope to pass through; multiple blades (2), one ends of the blades (2) respectively forming connection ends, and the connection ends of the respective blades (2) being pivotally connected to an inner wall of the channel in a circumferential direction of the channel to enable expansion and retraction of an operation means formed from the multiple blades (2); and a control means connected to the fixing means (1), the control means acting on the operation means to drive the operation means to expand or retract and to limit the respective blades (2) of the operation means to certain angular positions. The expander can cooperate with the lumbar microendoscope, and can prevent epithelial tissue from being excessively expanded.

Description

Propeller

Technical field

The present invention relates to a spreader, and more particularly to a spreader that can be used in conjunction with a disc mirror.

Background technique

Intervertebral discoscopy (MED) is essentially different from previous percutaneous discoscopy. It combines traditional open discectomy with endoscopic techniques and is minimally invasive and endoscopic in traditional lumbar disc surgery. The surgical field can be clearly displayed on the monitor, and with special surgical instruments, the incision is small, the tissue area is small, the bleeding is small, the normal tissue damage is small, and the pressure of the dural sac and the nerve root can be directly observed. And under direct vision operation, the nerve root decompression is thorough, can reduce the occurrence of complications such as nerve vascular injury while obtaining satisfactory and reliable curative effect, and the operation of lumbar intervertebral disc nucleus pulpectomy and nerve root channel cleaning can be completed by using the disc mirror Therefore, it is suitable for most types of lumbar disc herniation.

The surgical indications for discoscopy are similar to those of conventional disc surgery, but the range is narrower. The best indication for discoscopy:

(1) lumbar disc herniation with root pain;

(2) Extremely lateral lumbar disc herniation;

(3) The contralateral recurrence of the original segment after surgery;

(4) Single-segment lateral crypt stenosis and/or nerve root canal stenosis.

The advantage of MED is minimally invasive. The anatomy can be seen clearly during surgery, and the lamina, articular processes, osteophytes, calcified ligaments, and prominent intervertebral disc tissue can be removed. The intervertebral disc mirror usually needs to be used with the distractor during the operation, but the prior art distractor is difficult to adapt to the disc mirror due to the structural limitation, which increases the operation difficulty of the user, and in addition, the prior art When the spreader is used, it not only expands the internal tissue, but also enlarges the internal space of the tissue, and also enlarges the wound on the epidermal tissue, which cannot meet the standard of minimally invasive surgery.

Summary of the invention

The problem to be solved by the present invention is to provide a spreader that can be used in conjunction with a disc mirror and that can avoid large expansion of the epidermal tissue.

In order to solve the above problems, the present invention provides a spreader for connecting to a disc mirror, the spreader comprising:

a fixing portion having a passage for the lens barrel of the disc mirror to pass through;

a plurality of blades, one end of each of which forms a connecting end, and the connecting ends of each of the blades are respectively pivotally connected to an inner wall of the channel along a circumferential direction of the channel, so as to be formed by a plurality of the blades The operating part can be opened or closed;

a regulating portion connected to the fixing portion, the regulating portion acting on the operating portion for driving the operating portion to open or close, and limiting each of the blades in the operating portion At this angular position.

Preferably, the passage has a cylindrical shape, and the passage is divided into a first portion and a second portion along an axial direction thereof;

The blade is a strip-shaped plate having a curved surface, and the plurality of the blades are divided into two groups, the first group of the blades are evenly disposed along an inner wall of the first portion, and the second group of the blades are along the second The inner walls of the portions are evenly disposed and offset from the first set of said vanes.

Preferably, the blades are four and are equally divided into two groups, and the lines of the two of the groups are perpendicular to the axis of the channel;

The four ends of the vanes extending out of the passage are flush.

Preferably, the inner wall of the channel is provided with a mounting slot corresponding to the connecting end of the blade, and the connecting ends of each of the blades are respectively pivotally connected to the corresponding mounting slots, and each of the mounting slots is A side of the fixed portion facing the blade tip is communicated to increase an expansion space of each of the blades.

Preferably, the connecting end of the blade has a protrusion located in the mounting groove, and a central portion of the protrusion is provided with an opening groove for dividing the protrusion into two parts in a direction parallel to the channel axis. The two parts are respectively pivotally connected to the groove wall of the mounting groove.

Preferably, the fixing portion is provided with a through hole corresponding to each of the mounting slots, and the regulating portion includes a through hole and is connected to the connecting end of the blade and can be vertically The direction of the channel axis is moved to drive the drive member that the blade is opened or collapsed.

Preferably, the driving member is an adjusting bolt, and the through hole is a threaded hole.

Advantageously, said disc mirror comprises a body having said barrel and associated with said body a connecting seat, the body being limited to the fixing portion by the connecting seat.

Preferably, the connecting base comprises a fixing plate connected to the body and a sleeve passing through the fixing plate for fitting into the passage of the fixing portion, the lens barrel is worn through the sleeve Provided in the passage, at least one end of the fixing plate extends outward along a surface of the plate to form a handle.

Preferably, the body is provided with a long hole in a direction perpendicular to the surface of the fixing plate, and the fixing plate is correspondingly provided with a threaded hole communicating with the long hole, and the long hole and the threaded hole are provided for wearing inside. a screw for supporting the body and capable of adjusting the height of the disc mirror relative to the spreader, and a plurality of trajectories are uniformly arranged on the fixing portion along the screw rotating around the lens barrel Corresponding to the screw corresponding to the screw, the limiting groove of the screw is limited.

The stent of the present invention has the beneficial effects of being able to expand only the internal tissue without changing the incision on the epidermal tissue, reducing the wound area, and at the same time being able to be used in conjunction with a disc mirror having a 90° eyepiece to assist the intervertebral disc mirror. The field of view is adjustable.

DRAWINGS

Figure 1 is a schematic view showing the structure of the spreader of the present invention.

Figure 2 is a cross-sectional view showing a partial structure of the spreader of the present invention.

Figure 3 is a perspective structural view of a blade in the spreader of the present invention.

Figure 4 is a front elevational view of the blade of the spreader of the present invention.

Reference mark:

1-fixed portion; 2-blade; 3-mounting groove; 4-bump; 5-open groove; 6-adjusting bolt; 7-first part; 8--tube barrel; 9-body; 10--fixing plate; Sleeve; 12-screw; 13-stop groove; 14-second part.

detailed description

The invention is described in detail below with reference to the accompanying drawings.

As shown in Figure 1, the present invention provides a spreader that can be coupled and used in conjunction with a disc mirror having a 90° eyepiece, the spreader comprising:

a fixing portion 1 having a passage for the lens barrel 8 of the intervertebral disc to pass through;

a plurality of blades 2, one end of the same side of the plurality of blades 2 respectively form a connecting end, and the connecting ends of the blades 2 are respectively pivotally connected to the inner wall of the channel along the circumferential direction of the channel, so that the operation portion formed by the plurality of blades 2 can be opened Open or close; and

a regulating portion connected to the fixing portion 1. The regulating portion is configured to drive the operating portion to open or close according to an actual need to open the angle of the internal tissue of the human body, that is, to drive the blades 2 to open or close, and at the same time Limiting the blade 2 to the angular position allows the spreader to stably expand the internal tissue of the human body to a desired extent.

As shown in Figure 1 and Figure 3, the channel in this embodiment is cylindrical, and the channel is divided into a first portion 7 and a second portion 14 along its axial direction;

The blade 2 is a strip-shaped plate having a curved surface, and the plurality of blades 2 are divided into two groups, the blades 2 in the first group are uniformly disposed along the inner wall of the first portion 7, and the blades 2 in the second group are along the second portion 14. The inner wall is evenly arranged and offset from the position of the blade 2 in the first group. For example, the second portion 14 of the passage corresponds to the portion between the blades 2 in the two adjacent first groups, and the blades 2 and the like in the second group are disposed. In this embodiment, four blades 2 are included and evenly divided into two groups. The lines of the two blades 2 in each group are perpendicular to the axis of the channel, and the ends of the four blades 2 extending out of the channel are flush. That is, the lengths of the two sets of blades 2 are not equal, and the arrangement can facilitate the medical personnel to control the distraction position.

Specifically, in this embodiment, the blade 2 is mounted, and the inner wall of the channel is provided with a mounting slot 3 corresponding to the connecting end of the blade 2, and then the connecting ends of the blades 2 are respectively pivotally connected to the corresponding mounting slot 3 Inside, the installation of each blade 2 is completed. Each of the mounting grooves 3 communicates with the side of the fixed portion 1 toward the end of the blade 2 to increase the expansion space of each of the blades 2. Since the inner side wall of the channel is a curved surface, in order to ensure the firmness of the blade 2 and the stable rotation, the connecting end of the blade 2 is further formed with a bump 4 located in the mounting groove 3, and the middle portion of the bump 4 is parallel An opening groove 5 is provided in the direction of the channel axis, and the opening groove 5 is used for dividing the protrusion 4 into two parts, and then the two parts are respectively pivotally connected to the groove wall of the mounting groove 3 to realize the whole installation of the blade 2. .

As shown in FIG. 3 and FIG. 4, the fixing portion 1 defines a through hole corresponding to each of the mounting slots 3, and the regulating portion includes a driving member that is disposed in the through hole. The drive member is coupled to the connecting end of the blade 2 located in the mounting groove 3 and is movable in the direction of the vertical passage axis to drive the blade 2 to rotate. The driving member in this embodiment is an adjusting bolt 6, and the through hole is a threaded hole, and the screw hole is disposed near the upper end of the blade 2. In a specific operation, the adjusting bolt 6 is rotated to move in the direction of approaching the blade 2, and when the adjusting bolt 6 comes into contact with the blade 2 toward the end of the blade 2 and pushes the blade 2, the upper portion of the blade 2 moves toward the channel axis. And the lower part of the blade 2 is moved in the reverse direction to achieve the distraction effect. When the upper ends of the blades 2 abut against the corresponding groove walls, the amount of movement of the lower ends of the blades 2 is the largest, that is, the opening angle of the spreader is maximum at this time. When the adjusting bolt 6 is reversely rotated, since the top thrust received by the upper portion of the blade 2 is reduced, it moves in a direction away from the channel axis and drives the blade. The lower portion of the sheet 2 is moved in the direction of the channel axis, and the lower ends of the blades 2 are correspondingly closed to achieve the effect of reducing the opening angle. In addition, since the spreaders of the present embodiment are independent of each other, the blades 2 can be realized by pushing the corresponding blades 2 when the human body tissue needs to be expanded in one direction. Moreover, since each of the blades 2 in the present embodiment is swingable relative to the fixed portion 1, each blade 2 has a large amount of movement at the lower portion during the expansion operation, thereby achieving expansion of the inside of the tissue without acting on the epidermal tissue. In this way, the damaged area of the epidermal tissue is small, that is, the wound of the patient is small, the true minimally invasive effect is achieved, and the pain of the patient can be alleviated. For example, the diameter of the MED working hole in the prior art is only 17 mm, which cannot be enlarged, and the use of the spreader in this embodiment can expand the inside of the surgical position to 34 mm, so that the two-stage lamina can be exposed, and the work of the epidermis The hole is unchanged, still only 17mm.

1 and 2, the intervertebral disc mirror includes a body 9 having a lens barrel 8 and a connecting seat connected to the body 9, and the body 9 is restrained on the fixed portion 1 by a connecting seat. The connecting seat specifically includes a fixing plate 10 connected to the body 9 and a sleeve 11 penetrating the fixing plate 10 for engaging the insertion portion of the fixing portion 1, that is, the interposing of the intervertebral disc mirror through the sleeve 11 and the through hole The limit is on the spreader. The body 9 and the connecting seat in this embodiment are fixed by bolts. The lens barrel 8 is bored in the passage of the fixing portion 1 through a sleeve. At least one end of the fixing plate 10 extends outwardly along the surface of the plate to form a handle for the operation of medical personnel.

Further, the end of the lens barrel 8 of the intervertebral disc mirror in this embodiment is a wedge end. In order to adjust the angle of view of the disc mirror, it can be realized by rotating the disc mirror or lifting the disc mirror. For the purpose of the adjustment, the body 9 is achieved. A long hole is arranged along the direction of the surface of the vertical fixing plate 10, and the fixing plate 10 is correspondingly provided with a threaded hole communicating with the long hole, and the long hole and the threaded hole are provided for supporting the body 9 and can adjust the relative position of the disc mirror The screw 12 of the height of the opening device, and for the better limiting screw 12, can provide a stable supporting force for the intervertebral disc mirror, and the trajectory of the fixing portion 1 is uniform when the screw 12 rotates one revolution around the lens barrel 8 A plurality of limiting recesses 13 for correspondingly engaging with the screw 12 to reach the limiting screw 12 are provided. The arrangement of the plurality of limiting grooves 13 can be evenly divided according to the angle, so that the medical staff can intuitively obtain the orientation of the tissue to be expanded in the tissue, and of course, the above-mentioned effect can be achieved by setting the scale according to the above-mentioned trajectory on the fixing portion 1.

In specific use, if you want to reduce or enlarge the field of view of the discoscope, the medical staff can rotate the disc mirror to the desired angular position as needed, and adjust the screw 12 so that the lower end protrudes into the corresponding limiting groove 13 The limiting screw 12 ensures that the intervertebral disc mirror is stably fixed at the angular position. In addition, it is also possible to reduce or lengthen the length of the lower extension sleeve 11 by rotating the screw 12, that is, to adjust the distance between the disc mirror and the fixed portion 1 (in the prior art, when a disc mirror is used, Most of them are connected with supporting devices, such as a support frame, etc., which can facilitate the user to limit the intervertebral disc mirror, so that the screw 12 can support the body 9 and the connecting seat with the aid of the supporting device. ).

The above embodiments are merely exemplary embodiments of the present invention, and are not intended to limit the invention, and the scope of the invention is defined by the claims. A person skilled in the art can make various modifications or equivalents to the invention within the spirit and scope of the invention, and such modifications or equivalents are also considered to fall within the scope of the invention.

Claims

A spreader for connecting to a disc mirror, wherein the spreader comprises:

a fixing portion having a passage for the lens barrel of the disc mirror to pass through;

a plurality of blades, one end of each of which forms a connecting end, and the connecting ends of each of the blades are respectively pivotally connected to an inner wall of the channel along a circumferential direction of the channel, so as to be formed by a plurality of the blades The operating part can be opened or closed;

a regulating portion connected to the fixing portion, the regulating portion acting on the operating portion for driving the operating portion to open or close, and limiting each of the blades in the operating portion At this angular position.
The spreader according to claim 1 wherein:

The passage has a cylindrical shape, and the passage is divided into a first portion and a second portion along an axial direction thereof;

The blade is a strip-shaped plate having a curved surface, and the plurality of the blades are divided into two groups, the first group of the blades are evenly disposed along an inner wall of the first portion, and the second group of the blades are along the second The inner walls of the portions are evenly disposed and offset from the first set of said vanes.
The spreader according to claim 2, wherein

The blades are four and are equally divided into two groups, and the lines of the two of the groups are perpendicular to the axis of the channel;

The four ends of the vanes extending out of the passage are flush.
The spreader according to claim 3, wherein the inner wall of the channel is provided with a mounting slot corresponding to the connecting end of the blade, and the connecting ends of the blades are respectively pivotally connected to the corresponding In the mounting groove, each of the mounting grooves communicates with a side of the fixing portion facing the blade end to increase an expansion space of each of the blades.
The spreader according to claim 4, wherein the connecting end of the blade has a projection located in the mounting groove, and a middle portion of the projection is provided in a direction parallel to the channel axis for The protrusion is divided into two parts of open slots, and the two parts are respectively pivotally connected to the groove wall of the mounting groove.
The spreader according to claim 4, wherein the fixing portion is provided with a through hole corresponding to each of the mounting grooves, and the regulating portion includes a through hole penetrating through the through hole and The connecting ends of the vanes are connected and are movable in a direction perpendicular to the axis of the passage to drive the drive member in which the vanes are opened or closed.
The spreader according to claim 6, wherein the driving member is an adjusting bolt, and the through hole is a threaded hole.
The spreader according to claim 7, wherein said intervertebral disc mirror comprises a body having said barrel and a connecting base connected to said body, said body being limited by said connecting seat at said On the fixed part.
The spreader according to claim 8, wherein the connecting base comprises a fixing plate connected to the body and a sleeve passing through the fixing plate for fitting into a passage of the fixing portion a barrel through which the barrel is inserted, and at least one end of the fixing plate extends outwardly along a surface of the plate to form a handle.
The spreader according to claim 9, wherein the body is provided with an elongated hole in a direction perpendicular to the surface of the fixed plate, and the fixed plate is correspondingly provided with a threaded hole communicating with the long hole. a long screw and a threaded hole are provided with a screw for supporting the body and capable of adjusting the height of the disc mirror relative to the spreader, the fixing portion is along the screw with the lens barrel The trajectory when the center rotates one turn is evenly provided with a plurality of limiting grooves for correspondingly engaging with the screw to limit the screw.