WO2019093723A1 - Effecteur terminal endoscopique pour chirurgie osseuse - Google Patents

Effecteur terminal endoscopique pour chirurgie osseuse Download PDF

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Publication number
WO2019093723A1
WO2019093723A1 PCT/KR2018/013290 KR2018013290W WO2019093723A1 WO 2019093723 A1 WO2019093723 A1 WO 2019093723A1 KR 2018013290 W KR2018013290 W KR 2018013290W WO 2019093723 A1 WO2019093723 A1 WO 2019093723A1
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WO
WIPO (PCT)
Prior art keywords
burr
bone
channel
endoscope
fluid
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Application number
PCT/KR2018/013290
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English (en)
Korean (ko)
Inventor
박일형
정상현
박철우
이현우
박영균
Original Assignee
경북대학교 산학협력단
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Publication date
Application filed by 경북대학교 산학협력단 filed Critical 경북대학교 산학협력단
Publication of WO2019093723A1 publication Critical patent/WO2019093723A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064—Constructional details of the endoscope body
    • A61B1/00071—Insertion part of the endoscope body
    • A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/313—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes
    • A61B1/317—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes for bones or joints, e.g. osteoscopes, arthroscopes

Definitions

  • the present invention relates to an endoscope end effector for bone surgery, and more particularly, to an endoscope end effector for bone surgery that incorporates various mechanisms required for orthopedic surgery.
  • Surgical robots are medical robots that perform surgeries by assisting doctors. Robotic surgery methods have been attracting much attention because they can be recovered quickly and can be operated accurately by optimizing the removal site.
  • Minimally invasive surgery is a new concept surgery that minimizes the damage of the body, improves the accuracy and safety of the surgery, and improves the survival rate and quality of life after surgery.
  • various types of manipulators for surgical robots are being developed.
  • the conventional end-effector therapy using end-effectors as described above can be used for the following purposes: 1) skin incision, 2) bone surface exposure by bypassing the muscles and important nerves / blood vessels, 3) bone window formation, 6) external fixation with a cast or anchor until the implanted bone is remodeled, 7) external fixation with a bone graft, It is undergoing a process of rehabilitation treatment.
  • One aspect of the present invention provides a flexible end effector incorporating a curettage mechanism and drug injection and suction and endoscopes required for orthopedic surgery.
  • Another aspect of the present invention provides a surgical device having a power transmission mechanism based on hollow buckets for sofas and hydraulic, pneumatic, flexible shafts, and the like.
  • An endoscope end effector for bone surgery includes: an insertion part inserted into a bone part bent so that a sole is required; A burr part mounted on a distal end of the insertion part so as to be able to sof a bone while rotating; A burr fastening part for rotating the burr part by the pressure of the fluid supplied through the insert part and mounting the burr part on the end of the insert part; One or more channels are formed in the longitudinal direction to penetrate through the insertion portion and the burr portion to form a rotational axis of the burr portion; And an endoscope inserted into the channel.
  • the burr portion includes: a body defining a through hole for inserting the channel portion in the longitudinal direction; A plurality of cutter blades formed on one side of the body and protruding in a wave pattern so as to be able to sof a bone while rotating; A plurality of turbine blades formed on the other side of the body, the turbine blades protruding at predetermined slopes; And a fastening groove formed between the cutter blade and the turbine blade and fastened by the burr fastening portion.
  • the burr part may further include a shielding layer between the turbine blade and the coupling groove so as to prevent fluid supplied to the burr coupling part from flowing out into the coupling groove.
  • the cutter blade may protrude in front of one end of the body.
  • the burr fastening portion is mounted to the insertion portion, and the inlet portion is formed in a narrowed shape to fasten the fastening groove, thereby providing a mechanical coupling space.
  • the burr engagement portion may provide a turbine room space for rotating the turbine blades with a fluid pressure.
  • the burr fastening portion may form a gap between the burr fastening portion and the fastening groove so as to allow the fluid that has passed through the turbine blade to flow out toward the cutter blade.
  • the insert may form one or more fluid supply conduits for transferring fluid to the burr engagement.
  • the fluid supplied through the insertion portion may be formed as a liquid or gas as a power source of the buckling portion.
  • the fluid supplied through the insertion portion may be a drug used for cleaning a lesion site so that when the power source of the buccal portion is formed of a liquid, the lesion can be simultaneously cleansed .
  • the channel portion includes: a first channel for inserting the endoscope; A second channel for injecting a drug for drug or bone formation; And a third channel for injecting or sucking the rinse solution into the lesion site.
  • the channel portion may include a bearing at a portion forming the rotating shaft of the buffer portion to reduce frictional force during rotation of the buffer portion.
  • the steering controller for controlling the steering angle and the support stiffness of the insertion portion;
  • a burr driver for adjusting the flow rate so that a soap amount required by the operator is output;
  • an endoscope controller that is mechanically and electrically connected to the endoscope, displays an image transmitted from the endoscope, and controls an image function required by the operator.
  • the device may further comprise a relationship / suction controller for controlling the injection or recovery of the cleaning agent for perfusion cleaning of lesion sites.
  • it may further comprise a cement infusion controller to control the infusion of the semi-solid medication for bone formation.
  • an end effector that performs only an endoscopic function is further expanded, and removal, drug injection, and suction functions necessary for orthopedic surgery are added to shorten workability and treatment time.
  • FIG. 1 is a view showing a schematic configuration of an endoscope end effector for bone surgery according to an embodiment of the present invention.
  • FIG. 2 is a view for explaining a method of applying an endoscope end effector for bone surgery according to an embodiment of the present invention.
  • Fig. 3 is a view for explaining the first embodiment of the bu er part in Fig.
  • FIG. 4 is a view for explaining a second embodiment of the bucker shown in Fig.
  • Fig. 5 is a view for explaining the burr fastening portion and the channel portion in Fig. 1. Fig.
  • FIG. 6 is a view for explaining an embodiment according to a flow method of a fluid.
  • FIG. 7 is a diagram showing a schematic configuration of an endoscope end effector for bone surgery according to another embodiment of the present invention.
  • FIG. 1 is a view showing a schematic configuration of an endoscope end effector for bone surgery according to an embodiment of the present invention.
  • the endoscopic end effector 10 for a bone surgery includes an insertion portion 100, a burr portion 200, a burr fastening portion 300, a channel portion 400, and an endoscope 500.
  • the insertion portion 100 is installed at one end thereof with a burr portion 200 mounted thereon and bent while being bent into a bone portion required by the burr portion 200.
  • the insert 100 may form one or more fluid supply tubes 110 that deliver fluid to the burr fastener 300.
  • the fluid supply tube 110 may be formed through the insertion portion 100 as described above, or may be formed using several of a plurality of channels formed in the channel portion 400, .
  • the fluid supplied through the insert 100 may be formed as a liquid or gas as a power source for the bucky 200.
  • the power source of the bucky 200 is formed of a liquid, A drug used for washing the lesion site can be used so that the washing action of the lesion site can be performed at the same time.
  • the burr part 200 is mounted on the distal end of the insertion part 100 by a burring coupling part 300 so as to be able to sofa the bone while rotating and is rotated by the fluid supplied through the insertion part 100 do.
  • the burr coupling part 300 rotates the burr part 200 by the pressure of the fluid supplied through the insertion part 100 and mounts the burr part 200 on the end of the insertion part 100.
  • One or more channels are formed through the channel part 400 in the longitudinal direction and inserted through the insertion part 100 from the insertion part 100 to the burr part 200 in the longitudinal direction, A protruded portion after penetrating through the fastening portion 300).
  • the endoscope 500 may be inserted into one of a plurality of channels formed in the channel unit 400 and may refer to a medical instrument or the like which allows a visceral organ or body cavity to be directly seen.
  • the use of the endoscopic end effector 10 for bone surgery for orthopedic surgery which is proposed in the present invention, enables the endoscopic operation of the bone, and provides advantages such as minimization of the surgical site, shortening of the operation and treatment time .
  • the present invention relates to an endoscopic end effector for bone surgery, which is intended for solving bone diseases.
  • diseases that can be applied include: 1) a simple bony cyst (SBC), an aneurysmal bone cyst ), Degenerative cystic change (DCC), and metastatic bone lesion.
  • SBC simple bony cyst
  • DCC Degenerative cystic change
  • metastatic bone lesion a simple bony cyst (SBC)
  • SBC bony cyst
  • DCC Degenerative cystic change
  • metastatic bone lesion a simple bony cyst
  • Periprosthetic osteolysis of the periosteal osteolysis which occurs after artificial joint replacement surgery, It is applicable to the diagnosis / treatment of cancer.
  • the endoscopic end-effector 10 for bone surgery having the above-described configuration is an end effector for orthopedic surgery having an insertion portion 100 which is a flexible power transmission mechanism.
  • the end effector 10 includes an insertion portion 100 and a burr 200 and a burr coupling part 300 as a rigid part.
  • Orthopedic surgery is a common surgical procedure required to treat bone disease, including: 1) operation to secure a passage for access to the lesion and removal of solid tissue within the lesion, 2) An endoscopic operation to view the state or treatment range, 3) a cleaning and inhalation operation to remove the broken solid tissue after the operation of the sofa in the lesion site, and 4) a drug injection process for treating the site where the tissue has been removed.
  • each surgical operation has been performed as a separate device.
  • the above-described surgical operation has been performed in such a manner that a large skin incision and a bone window are formed to scrape lesions.
  • the endoscope technology and the respective devices necessary for the orthopedic surgery are integrated, and the flexible power transmission mechanism is incorporated, Even with minimal incision and perforation, it is possible to simultaneously perform the treatment method required for the conventional bone disease treatment, thereby enabling the minimization of the lesion and accurate and intuitive operation.
  • the end effector 10 is configured such that: 1) the power of the buccal part 200 is adjusted to the pressure, air pressure 2) When the power of the buccal part 200 is hydraulic type, the supplied fluid is used for cleaning the lesion area, and it can perform the cleaning action of burr power and lesion, and 3)
  • the hollow burr part 200 is rotated with the channel part 400 through which the endoscope and the drug infusion / suction device pass by using the hollow burr part 200 as a fixed shaft, and 4) (Or cement for bone formation) can provide more than two channels for the injection channel, lesion cleansing injection, suction channel.
  • the endoscopic end effector 10 having the above-described structure can further shorten the workability and the treatment time by further expanding the endoscopic function and adding the removal, drug injection, and suction functions necessary for orthopedic surgery.
  • Fig. 3 is a view for explaining the first embodiment of the bu er part in Fig.
  • the burr part 200 includes a body 210, a plurality of cutter blades 220, a plurality of turbine blades 230, and a fastening groove 240.
  • a plurality of cutter blades 220 are formed on one side of the body 210 and a plurality of turbine blades 230 are formed on the other side of the body 210. Between the cutter blade 220 and the turbine blade 230, And a through hole 211 for inserting the channel part 400 is formed in the longitudinal direction by a hollow hole.
  • the cutter blade 220 is formed on one side of the body 210 and is protruded in a wavy pattern so as to be able to sof the bone while rotating.
  • the cutter blade 220 defines its shape as a wavy pattern for an effective bone sofa, but may be shaped in a straight line in response to surgical factors, such as bone hardness or bone shape, , A concave-convex shape, a bundle shape, or the like.
  • the cutter blade 220 not only can form blades outwardly as shown in Fig. 3 of the body 210, but also protrudes toward one side of the distal end, It is possible to make a sofa more efficiently.
  • the cutter blade 220 may form a space between the blades and the blades to allow fluid supplied through the blades 300 to flow into the formed space.
  • the cutter blade 220 preferably sharpens the outer blades to effectively sofa the bone.
  • the turbine blade 230 is formed on the other side of the body 210 and protrudes at a predetermined inclination (for example, 30 to 50 degrees).
  • the turbine blade 230 is located in the inner space of the burr coupling part 300, and by the same principle as the power generation principle in which the turbine connected to the generator by the flow of water in the hydroelectric power plant rotates, It is possible to rotate in the clockwise or counterclockwise direction corresponding to the oblique direction by the pressure generated by the flow of the fluid supplied to the burring coupling part 300 as shown in FIG.
  • the buck converter 200 is driven by the hydraulic pressure formed by the fluid, so that the overall structure can be simplified, It is possible to prevent malfunctions that may occur and also to simultaneously perform the driving force generation and the cleaning action by using the medicine used for cleaning the lesion site as described above.
  • the coupling groove 240 is formed between the cutter blade 220 and the turbine blade 230 and is fastened by the burring coupling part 300.
  • the fluid that has passed through the fluid supply pipe 110 and has rotated the burr part 200 is rotated by rotating the turbine blade 230, The cutter blade 220 and the cutter blade 220.
  • the cutter blade 220 passes through the clearance between the clamping grooves 240 and flows out in the direction of the cutter blade 220 and is sprayed through a space formed between the blade of the cutter blade 220 and the cutter blade 220, And flows back into the burring coupling part 300 through the fluid supply pipe 110 other than the fluid supply pipe 110 which has passed through.
  • the bucker 200 having the above-described structure is configured to break a solid tissue at a lesion site, and includes a cutter blade 220 as a cutter blade for soaking a solid tissue, And a turbine blade 230 that is a turbine blade for receiving power.
  • FIG. 4 is a view for explaining a second embodiment of the bucker shown in Fig.
  • the burr part 200 includes a body 210, a plurality of cutter blades 220, a plurality of turbine blades 230, a fastening groove 240, and a shielding film 250.
  • the body 210, the plurality of cutter blades 220, the plurality of turbine blades 230, and the coupling grooves 240 are the same as those of FIG. 3, and thus description thereof will be omitted.
  • the shielding film 250 is formed between the turbine blade 230 and the fastening groove 240 to prevent the fluid supplied to the burring fastening part 300 from flowing out into the fastening groove 240.
  • the fluid that has passed through the fluid supply pipe 110 and has rotated the buoyancy portion 200 passes through the coupling groove 240 after rotating the turbine blade 230
  • the turbine blade 230 rotates as shown in FIG. 6 (a) and then flows through the fluid supply pipe 110 other than the fluid supply pipe 110 that has flowed into the burr coupling part 300 after passing through the fluid supply pipe 110 I will go back.
  • Fig. 5 is a view for explaining the burr fastening portion and the channel portion in Fig. 1. Fig.
  • the burr coupling part 300 is mounted on the insertion part 100 and is formed in a shape in which the entrance part is narrowed in order to fasten the coupling groove 240 to provide a mechanical coupling space .
  • the turbine blade 230 is positioned in an empty space formed inside the burr coupling portion 300 due to the narrowing of the inlet, as described above, It is possible to provide a turbine room space in which the turbine blades 230 are rotated by the pressure of the fluid supplied from the unit 100.
  • the burr coupling part 300 may form a gap with the coupling groove 240 so that the fluid that has passed through the turbine blade 230 may flow out toward the cutter blade 220.
  • the fluid that has passed through the turbine blade 230 can flow in the direction of the cutter blade 220 through the above-described gap as shown in FIG. 6 (b) instead of returning to the insertion portion 100 again .
  • the channel unit 400 may include a first channel 410, a second channel 420, and a third channel (not shown in the drawings for convenience of explanation).
  • the first channel 410 inserts the endoscope 500.
  • the second channel 420 injects a drug for drug or bone formation.
  • the third channel injects or sucks the cleaning liquid into the lesion site.
  • the first channel 410, the second channel 420, or the third channel are not all formed in the same shape in a lump, but the shape or diameter of each of the first channel 410, the second channel 420, .
  • the channel portion 400 having the above-described structure is provided with a bearing (not shown in the drawings for the sake of explanation) to reduce frictional force when the burr portion 200 is rotated, .
  • FIG. 7 is a diagram showing a schematic configuration of an endoscope end effector for bone surgery according to another embodiment of the present invention.
  • the endoscopic end effector 20 for a bone surgery includes an insertion portion 100, a burr portion 200, a burr fastening portion 300, a channel portion 400, an endoscope 500, a steering controller 600, a burr driver 700, an endoscope controller 800, a relationship / suction controller 900, and a cement injection controller 1000.
  • the insert 100, the burr 200, the burr coupling 300, the channel 400, and the endoscope 500 are the same as those of FIG. 1, and a description thereof will be omitted.
  • the steerable sheath controller 600 controls the steering angle and the support stiffness of the insert 100, which is the flexible portion of the present invention, and the mechanisms for forming the steering angle and the support stiffness include metal wires and mechanical A manipulator, and a power source or machine or an electric actuator of a user may be used as a power source.
  • the burr driver 700 controls the flow rate by which the buccal part 200 is rotated so as to output the amount of the sofa required by the operator so that the amount of the soap required by the operator Hydraulic, pneumatic, and other power sources such as a hydraulic shaft and a hydraulic shaft so that a sofa amount (a cutting amount) required by an operator is output when a mechanical method such as a flexible shaft is used.
  • the device can be adjusted.
  • An endoscope camera controller 800 is mechanically and electrically connected to the endoscope 500 and displays an image transmitted from the endoscope 500 and controls an image function required by the operator.
  • the endoscope controller 800 may include a power supply unit 810 for supplying power required by a light emitting device such as an LED for emitting light from the endoscope 500 and illuminating a lesion site.
  • a light emitting device such as an LED for emitting light from the endoscope 500 and illuminating a lesion site.
  • the power supply unit 810 provides an optical source to the light optical apparatus provided in the endoscope device, and controls the amount of light required by the operator.
  • the irrigation / suction controller 900 controls the injection or recovery of the cleaning drug for perfusion cleaning of the lesion site.
  • a cement insertion controller 1000 controls the injection of semi-solid medication for bone formation.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Biomedical Technology (AREA)
  • Medical Informatics (AREA)
  • Optics & Photonics (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Biophysics (AREA)
  • Engineering & Computer Science (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne un effecteur terminal endoscopique pour chirurgie osseuse, comprenant : une partie d'insertion insérée de manière pliable dans une partie osseuse nécessitant une légère fracture; une partie fraise montée à l'extrémité de la partie d'insertion de façon à fracturer légèrement l'os tout en tournant; une partie de fixation de fraise, qui fait tourner la partie fraise sous l'effet de la pression de fluide fournie après le passage à travers la partie d'insertion et qui permet à la partie fraise d'être montée à l'extrémité de la partie d'insertion; une partie passage comportant un ou deux passages ou davantage formés par pénétration dans la direction longitudinale et formant l'axe de rotation de la partie fraise lors de son insertion par pénétration en partant de la partie d'insertion et en allant vers la partie fraise dans la direction longitudinale; et un endoscope inséré dans les passages.
PCT/KR2018/013290 2017-11-10 2018-11-05 Effecteur terminal endoscopique pour chirurgie osseuse WO2019093723A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
KR10-2017-0149434 2017-11-10
KR1020170149434A KR101990207B1 (ko) 2017-11-10 2017-11-10 뼈 수술용 내시경 엔드 이펙터

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KR102235681B1 (ko) 2019-12-03 2021-04-05 주식회사 딥노이드 수술 위치 항법 장치 및 그 방법

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JPH09187464A (ja) * 1996-01-05 1997-07-22 Osada Res Inst Ltd 外科用ハンドピース
JP2002537014A (ja) * 1998-06-09 2002-11-05 ヌバシブ， インコーポレイテッド 患者の椎骨間空間に入るための腸骨間アプローチ
JP2003519525A (ja) * 2000-01-10 2003-06-24 ハイドロシジョン・インコーポレーテッド 一体化した電気焼灼具を備えた外科用器具
JP2009279411A (ja) * 2008-05-20 2009-12-03 Olympus Medical Systems Corp 内視鏡装置
JP2010022758A (ja) * 2008-07-24 2010-02-04 Olympus Corp 内視鏡装置

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AU7139994A (en) 1988-06-13 1995-01-03 Karlin Technology, Inc. Apparatus and method of inserting spinal implants
KR101151738B1 (ko) 2010-02-17 2012-06-15 전남대학교산학협력단 다수 다관절 엔드-이펙터를 가진 튜블라형 수술로봇 매니퓰레이터
US20130150831A1 (en) 2011-12-13 2013-06-13 Symmetry Medical New Bedford, Inc System and method for an articulating distal end of an endoscopic medical device
KR101475665B1 (ko) 2013-05-24 2014-12-23 주식회사 고영테크놀러지 비강용 수술도구 및 이를 이용한 수술도구 어셈블리
JP6214464B2 (ja) 2014-05-15 2017-10-18 オリンパス株式会社 内視鏡システム

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH09187464A (ja) * 1996-01-05 1997-07-22 Osada Res Inst Ltd 外科用ハンドピース
JP2002537014A (ja) * 1998-06-09 2002-11-05 ヌバシブ， インコーポレイテッド 患者の椎骨間空間に入るための腸骨間アプローチ
JP2003519525A (ja) * 2000-01-10 2003-06-24 ハイドロシジョン・インコーポレーテッド 一体化した電気焼灼具を備えた外科用器具
JP2009279411A (ja) * 2008-05-20 2009-12-03 Olympus Medical Systems Corp 内視鏡装置
JP2010022758A (ja) * 2008-07-24 2010-02-04 Olympus Corp 内視鏡装置

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KR20190053492A (ko) 2019-05-20

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