WO2019098444A1 - Dispositif de gaine pour chirurgie spinale endoscopique biportale - Google Patents

Dispositif de gaine pour chirurgie spinale endoscopique biportale Download PDF

Info

Publication number
WO2019098444A1
WO2019098444A1 PCT/KR2017/013881 KR2017013881W WO2019098444A1 WO 2019098444 A1 WO2019098444 A1 WO 2019098444A1 KR 2017013881 W KR2017013881 W KR 2017013881W WO 2019098444 A1 WO2019098444 A1 WO 2019098444A1
Authority
WO
WIPO (PCT)
Prior art keywords
guide tube
saline solution
guide
endoscope
valve body
Prior art date
Application number
PCT/KR2017/013881
Other languages
English (en)
Korean (ko)
Inventor
정민호
손상규
Original Assignee
주식회사 엔도비전
정민호
손상규
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 주식회사 엔도비전, 정민호, 손상규 filed Critical 주식회사 엔도비전
Priority to US16/763,175 priority Critical patent/US11457909B2/en
Priority claimed from KR1020170162530A external-priority patent/KR102056153B1/ko
Publication of WO2019098444A1 publication Critical patent/WO2019098444A1/fr

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments

Definitions

  • the present invention relates to minimally invasive bi-axial endoscopic surgery (UBE), and more particularly, to a method of minimizing the incidence of surgery in a surgical field by maintaining continuous supply of saline solution to the intra-body surgical site,
  • UBE minimally invasive bi-axial endoscopic surgery
  • the present invention relates to a bidirectional spinal endoscopic surgery sheath device capable of greatly improving the accuracy of the operation.
  • the human vertebrae consist of seven cervical vertebrae, twelve thoracic spines, five lumbar vertebrae, five sacrum bones, and four sacrumes, a tail bone. These vertebrae are connected by joint nodes, and each joint is composed of intervertebral discs.
  • the vertebrae having such a structure have an important function of protecting the internal organs as well as supporting the posture.
  • percutaneous endoscopic interdisal decompression which is a minimally invasive spinal surgery using an endoscope
  • percutaneous endoscopic decompression of the endoscope itself is a very difficult operation, and difficulty may arise due to poor visual field despite the use of a microscope or spinal endoscope as an auxiliary device.
  • Percutaneous 2-port endoscopic decompression a recent endoscopic technique, has the advantage of being able to reduce muscle damage compared to percutaneous 1-port proximal extracapsular epidural surgery and to easily observe transverse muscles at deep positions.
  • the percutaneous two-port endoscopic decompression also referred to as bidirectional vertebral endoscopic surgery, can provide a clear view of the surgical site as compared to the conventional one-port endoscopic decompression technique, thereby solving various technical difficulties.
  • Korean Patent Registration No. 10-1744459 discloses a set of surgical instruments for posterior two-channel vertebral endoscopic surgery. However, only a few surgical instruments have been disclosed, and a specific technique for securing a clear view during the bi- The surgical apparatus is not disclosed.
  • the present invention has been made to overcome the above-mentioned problems, and it is an object of the present invention to provide a continuous and smooth supply of saline solution to the intra-body surgical site during surgery, and to provide an optimal bi-directional vertebral endoscope operation
  • the present invention has been made in view of the above problems.
  • a bidirectional vertebral endoscopic surgery sheath device is a hollow tube-shaped member that extends in the longitudinal direction and has a distal end portion thereof reaching a target portion in the body during use, A tube; A saline solution guiding unit installed at a rear end of the guide tube for guiding the saline solution injected from the outside into the guide tube; And an adapter unit which is located at the rear end of the guide tube and guides the probe of the endoscope camera to be used to the guide tube.
  • the saline solution inducing unit may include: A valve body for passing saline flowing through the inlet port to the guide tube, and a flow control valve mounted on the valve body for controlling the flow rate of the saline solution passing through the valve body.
  • a damping chamber is provided between the valve body and the guide tube for receiving the saline solution passing through the valve body and guiding the saline solution to the guide part.
  • the valve body is characterized in that at least one or more of the valve bodies are mounted around the damping chamber so as to increase the supply amount of the saline solution to the damping chamber.
  • a linear guide groove for guiding the saline flowing into the guide tube in the longitudinal direction of the guide tube is formed.
  • a plurality of linear guide grooves are arranged in parallel in the circumferential direction of the inner circumferential surface of the guide tube, and support protrusions are formed between the linear guide grooves to contact the probe of the endoscope camera and support the probe.
  • the adapter unit may further include: And a holder for holding the endoscope camera fixed to the sheath device.
  • the saline solution discharged from the guide tube is guided so as to flow out in the radial direction of the guide tube, and protrusions and grooves are repeatedly formed in a wave pattern along the circumferential direction of the guide tube.
  • the bidirectional spinal endoscopic surgery sheath device of the present invention as described above is capable of continuously and smoothly supplying saline to the surgical site during surgery and secures the best view according to the cleaning of the lens by the saline solution, As much as possible.
  • the bidirectional spinal endoscopic surgery sheath device of the present invention as described above is capable of continuously and smoothly supplying saline to the surgical site during surgery and secures the best view according to the cleaning of the lens by the saline solution, As much as possible.
  • FIG. 1 is a view for explaining a basic concept of a bi-directional vertebral endoscopic surgery.
  • bidirectional vertebral endoscopic surgery is performed by drilling two holes, that is, an operation hole (B) and an endoscope hole (A) Punch 50 and the shaver device 30 or the high-frequency probe 40 or the K-punch 50 and inserts the endoscope device 60 into the endoscope cavity A.
  • the saline solution 28 is injected through the endoscope device 60 to induce the saline solution to flow through the surgical site, thereby allowing the saline solution to wash away the debris from the surgical site.
  • the used saline is discharged to the outside of the body through the operation hole (B).
  • the endoscope apparatus 60 functions not only to visually confirm the in-vivo surgical site, but also serves as a function of supplying saline into the body.
  • Bidirectional vertebral endoscopic surgery approaches the surgical site through a different pathway between the surgical tool and the endoscope, so it is easier to secure the field of view than the surgery in which the previous one incisional hole is formed. Observation in spinal surgery is a very important factor.
  • the bidirectional vertebral endoscopic surgery does not share the hole through which the surgical tool passes with the endoscope, so that the motion is relatively free, thereby enabling more efficient surgery.
  • the surgical instrument includes a wide variety of surgical tools and includes a surgical tool set 10, an endoscope apparatus 60, a shaver apparatus 30, a high frequency probe 40, and a K-punch 50.
  • FIGS. 2A and 2B are views showing a set of surgical tools 10 that can be used for the surgery shown in FIG. 1, and FIGS. 3A to 3D are perspective views showing the muscle retractor shown in FIG. 2A.
  • FIGS. 4 to 15 are views for explaining almost all the surgical instruments shown in FIG. 1.
  • the surgical tool set 10 is provided with an extension tube 11 for expanding the size of the surgical hole B and an operation sharing device 22 for holding the expanded surgical hole B .
  • the extension tube 11 is a tool for securing a space for inserting other surgical instruments into and from the surgical ball formed at the surgical site during bi-directional vertebral endoscopic surgery, and is a tool for sequentially expanding the surgical ball by size. That is to say, the skin is cut to a minimum size with a surgical knife, and then the step is gradually inserted to enlarge the hole.
  • the extension tube 11 takes the form of a hollow tube having different diameters and lengths, as shown in Fig.
  • the inner diameter and the outer diameter of the expanded tubular body are increased by 2 mm from the first expanded tubular body 11a having an inner diameter of 3 mm and an outer diameter of 5 mm, and six types are provided from the first expanded tubular body 11a to the sixth expanded tubular body 11a .
  • the first to sixth extension tubes 11 are selectively used as needed.
  • a scale (not shown) indicating the depth of insertion into the surgical hole may be marked on the outer circumferential surface of the extension tube 11.
  • the surgical shaper 22 is a rod-like tool that is inserted into an operation hole to maintain the surgical hole secured by the extension tube 11 and protect the nerve.
  • the diameter of the surgical stapler corresponds to the diameter of the enlarged tubular body.
  • the surgical tool set 10 is provided with a muscle separator 13, a both-end retractor 19, a muscle retractor 12, an inhaler 20, an in-disc washer 21, a cage guider 14, An osteotomy chart 16, a main chip impactor 15, a curved brochure 18, and the like.
  • the muscle separator 13 is a tool for opening the bones and muscles of the surgical site in a state of being inserted into the ensured incision and securing an access path and a surgical space for a tool used in a subsequent operation. In other words, it is inserted between the micro-muscles of the muscle rather than the muscle.
  • the muscle separator 13 is composed of a blade portion 13b and a handle portion 13a.
  • the blade portion 13b takes a streamlined shape in order to minimize the wound on the surgical site.
  • the both-end retractors 19 are inserted between the operative spaces created by the muscle separator 13, and are tools used for peeling the nerve roots from the bone or the sphincter, or peeling the muscles or ligaments.
  • the two-end retractors 19 are adapted to vary the angle of the tips 19b formed at both ends to delaminate and remove neurological risk factors or apply bone wax to the bleeding point during bone hemorrhage.
  • the angle of the tip portion 19b ranges from 5 degrees to 35 degrees, and the width varies to 4 mm / 3 mm / 2 mm. The angle and width of the tip portion 19b may vary.
  • a handle 19a is located at the center of the both-end retractor 19, a handle 19a is located.
  • the handle 19a may have a recessed groove for preventing the user's finger from slipping or a predetermined pattern of irregularities for increasing friction.
  • the muscle retractor 12 is a tool used to guide a path for inserting and removing a surgical tool by securing a certain water pressure in the surgical space and the surgical space by pulling the muscles. As shown in FIGS. 3A to 3D, A first bent portion 12a is formed at the center and a second bent portion 12b is formed at one end.
  • the bending angle of the first bending portion 12a is about 120 degrees, which is an ideal angle in ergonomic and kinematic when the surgical tool is inserted and the surgical tool is inserted.
  • the outer portion of the first bent portion 12a has a semi-tubular shape and the second bent portion 12b has a shape bent in the same direction as the first bent portion 12a It is possible to fix the muscles to the nerve roots by taking a half-folded shape.
  • the opposite side formed in the form of a half-pipe may serve to guide a path through which a soft tissue such as a ligament is pulled out, a surgical tool for cutting or inserting a disc, or the like is inserted or removed.
  • the width of the muscle retractor 12 may be variously set to 4 mm / 10 mm or the like, and a muscle retractor of an appropriate size may be selected according to the surgical site.
  • the muscle retractor helps open and close the surgical hole and maintains the operative space and water pressure so that the master can check the sharp image of the surgical site.
  • pressurization and decompression of the nerve roots can be controlled to achieve smooth operation without damaging the nerve roots.
  • the inhaler 20 is a tool for drawing blood or saline solution or soft tissue (which is being injected for surgery) as well as tissue debris generated during surgery.
  • a certain pressure e.g., 30 to 50 mmHg
  • a constant pressure needs to be applied to the body.
  • the suction unit 20 includes a handle 20a to which a discharge port is connected and a suction pipe unit 20b having a curved shape and having a suction hole 20c at the tip thereof.
  • the angle of the suction pipe portion 20b may be about 130 to 150 degrees, and the diameter may be 3 to 5 mm.
  • the in-disc washing machine 21 is a tool used to remove debris and the like after making a space for inserting an artificial disc into the disc space. That is, before and after the insertion of the artificial disc, the surrounding debris or the like is discharged so as not to remain in the body. It is possible to precisely grasp the part to be cleaned while securing sufficient visibility by the disk washing machine 21, and it is possible to quickly wash and wash water.
  • the disc washing machine 21 includes a handle 21a on which a washing water inlet 21d is formed and a water tube 21b bent at an appropriate angle to secure a view of the user and having a discharge hole 21c formed at the tip thereof, .
  • the bending angle of the water tube portion 21b is about 111 to 130 degrees. If the bending angle is less than 111 degrees, the user's view is obscured. If it is more than 130 degrees, the user's gaze must be lowered to see the discharge hole 21c.
  • the cage guider 14, the present chip cannula 15, the osteotomy 16, and the on-chip impactor 17 are tools that are used to insert an artificial disk into a disk space.
  • the cage guider 14 is a tool used to seat a cage (not shown) in the disk space.
  • One end of the cage guider 14 is provided with a carrying portion 14b on which a cage can be placed and a grip portion 14a is formed on the other end.
  • the present chip cannula 15 is a tool used to collect the bones and insert them into the disc space.
  • a funnel-shaped collecting part 15a is provided, and the collecting part 15a collects the texture.
  • the osteotomy 16 is a tool used to cut unnecessary bone during surgery. At the distal end of the osteotomy 16, a cutting edge 16b for cutting the bone is formed. It is a matter of course that the handle 17a is located on the opposite side.
  • the present chip impactor 17 is an artificial disk inserted in the disk space or a tool for striking to accurately hold the collected burs.
  • the tip portion of the main chip impactor 17 is provided with a tip portion 17b which is in contact with an object to be hit and a grip portion 17a is provided on the opposite side.
  • the curved bifurcation 18 is a tool for removing the end plate between the vertebrae and the disc, and the distal end is bent to take the form of a hook. Since one end of the curved eliminator is formed in the shape of a hook, the end plate positioned between the spine and the disk can be easily accessed and removed.
  • the endoscope apparatus 60 includes an endoscope 63 for use in surgery and a sheath device 61 for receiving and supporting the endoscope 63 therein.
  • Fig. 9 is an exploded perspective view of the endoscope apparatus 60
  • Fig. 10 is a sectional view taken along the line X-X of Fig. 11 is a sectional view of the guide tube 61a shown in FIG.
  • the endoscope camera 63 is an apparatus for confirming and photographing a surgical site in the body and includes a flexible probe 63a extending in the longitudinal direction and incorporating an optical cable and a lens 63b provided at the tip of the probe 63a And a lens barrel 63c provided at the rear end of the lens 63b.
  • the endoscope camera (63) includes an imaging control device for capturing an image or recording an image, a light source connected to a guide cable for illuminating a photographed region, a light source for emitting light to a distal end of the endoscope A guide cable, and an endoscope tray for storing and facilitating movement of the endoscope camera.
  • the sheath device 61 constitutes one endoscope device 60 in combination with the endoscope camera 63 and serves to support the endoscope camera 63 during operation and to secure a field of view. In fact, since the probe 63a of the endoscope camera is very thin and well bent, the lens 63b can not reach the target point in the body, so the sheath device 61 is used.
  • the sheath device 61 includes a guide tube 61a, a damping chamber 61m, a valve body 61b, and an adapter 61s.
  • the guide tube 61a is a hollow tubular member extending in the longitudinal direction and having a distal end portion reaching a target portion in the body in use.
  • the length of the guide tube 61a may be varied as needed.
  • the guide tube 61a is inserted into the body through the path secured by the above-mentioned extension tube 11.
  • the guide groove 61p is a groove extending along the longitudinal direction of the guide tube 61a and is an induction groove for guiding saline supplied from the outside to the discharge port 61f.
  • linear protrusions 61r are formed between the respective guide grooves 61p.
  • the linear protrusions 61r are protrusions formed in parallel with the guide grooves 61p, and a plurality of the guide protrusions 61r are disposed in parallel to form guide grooves 61p.
  • the linear protrusions 61r and the guide groove 61p are uniformly spaced along the circumferential direction of the guide tube 61a.
  • the linear protrusion 61r partially contacts the outer circumferential surface of the probe 63a inserted into the space portion 61n of the guide tube 61a to support the probe 63a.
  • the diameter of the virtual cylinder connecting the upper end of the linear protrusion 61r is larger than the diameter of the probe 63a. Therefore, the probe 63a can move vertically and horizontally and move smoothly in the longitudinal direction within the space portion 61n.
  • a plurality of protrusions 61h and a groove 61g are formed at the tip of the guide tube 61a.
  • the protrusion 61h protrudes in the tip direction of the guide tube 61a, that is, the discharge direction of the saline solution, and the groove 61g is a depressed portion in the opposite direction.
  • the projection 61h and the groove 61a are repeatedly formed in a wave pattern along the circumferential direction of the guide tube 61a.
  • the projection 61h and the groove 61a serve to guide the saline solution discharged from the guide tube to flow out in the radial direction of the guide tube. For example, when the distal end of the guide tube 61a is blocked by the muscles, the saline solution is supplied through the groove 61a.
  • a side slit 61k is formed on the side of the distal end of the guide tube 61a.
  • the side slits 61k are for adjusting the flow direction of the saline solution. In other words, during bidirectional vertebral endoscopic surgery, the flow direction of the saline solution is adjusted so that the saline solution flows by gravity while easily cleaning the lens 63b.
  • the side slits 61k also serve as a passage for saline solution.
  • the saline solution introduced into the guide tube 61a is discharged through the side slits 61k by the action of gravity to wash away the tissues and blood of the affected area to secure a field of view.
  • the adapter 61s holds a position of the endoscope camera 63 with respect to the sheath device 61 and has a holder 61d for supporting the endoscope camera 63.
  • the rear end of the guide tube 61a is opened to the rear of the holder 61d.
  • the damping chamber 61m is a space part connected to the rear end of the guide tube 61a.
  • the damping chamber 61m receives the saline solution supplied through the valve body 61b once and then receives the saline solution through the guide tube 61a .
  • the damping chamber 61m By applying the damping chamber 61m, the flow rate of the saline solution supplied to the guide tube 61a is maintained constant. Without the hermetically closed chamber 61m, the change in the flow rate of the saline solution supplied through the saline supply tube (27a in Fig. 1) is directly transmitted to the guide tube 61a. The variation of the discharge flow rate of the saline solution through the discharge port 61f of the guide tube 61a is severe. The capacity of the damping chamber 61m may be varied as needed.
  • Two valve bodies 61b are provided in the periphery of the damping chamber 61m and a flow control valve 61e is provided in each of the valve chambers 61b.
  • the flow rate control valve 61e is for controlling the flow rate of the saline solution passing through the valve body 61b, and is operated by a user.
  • the damping chamber and the valve body serve as a saline directing part for guiding the saline solution into the guide tube 61a.
  • Reference numeral 61c denotes an inlet through which the saline supply tube 27a is connected.
  • the saline solution moved through the saline solution supply tube 27a reaches the affected part through the valve body 61b, the damping chamber 61m and the guide tube 61a through the injection port 61c.
  • the shaver device 30 includes a hand path 30b, which is connected to an external wireless foot switch and is provided with an operation switch (not shown), a distal end of the handpiece 30b And a drill burr 30a.
  • the drill bur is a part for grinding bone, and there are various kinds, for example, a round drill bur and a diamond drill bur can be applied.
  • the diamond drill bit is formed with a cutting tip for cutting a bone. Unlike the conventional drill burr used in endoscopic surgery, the cutting tip is embossed like an industrial diamond. Therefore, the depth of cutting the bone can be finely adjusted, and bleeding can be minimized.
  • the cutting tip of the diamond drill bit may be realized in other shapes such as a triangular shape as well as a round shape.
  • the diamond drill bit may further include a shield portion surrounding one side of the cutting tip to cut only unnecessary portions without damaging the normal tissue portion.
  • the high-frequency probe 40 is a tool used to cut soft tissues such as discs, epidural fat, ligaments, and the like.
  • soft tissues such as discs, epidural fat, ligaments, and the like.
  • the high frequency probe 40 of the present invention has the casing 40c, the insertion rod 40a, And an electrode tip 40b formed at the distal end of the insertion rod 40a to apply heat to the treatment area.
  • it may further include a power line capable of supplying power to the high-frequency probe 40, and a discharge tube for discharging saline in the body to the outside of the body may be extended to the outside of the casing 40c.
  • the electrode tip 40b can be fitted to the insertion rod 40a, and includes a heating part and a shield part.
  • a plurality of protrusions for maintaining a certain distance from the human tissue are formed in the heat generating portion, and the soft tissue around the heat generating portion is cut out.
  • the shield portion isolates normal tissues such as nerves near the treatment site from the heating portion. Therefore, it is possible to prevent the normal tissue near the treatment site from suffering thermal damage.
  • the K-punch 50 is a tool used to remove and remove yellow ligaments, soft tissues, and the like.
  • the K-punch 50 includes a removal part 50a for removing a yellow band or soft tissue to be removed, a shaft 50b, and a handle 50c for supporting the shaft.
  • the shaft can be manually or automatically pivoted clockwise or counterclockwise. Therefore, it is possible to grasp at a comfortable angle regardless of the position of the tissue to be removed.
  • 15 is a block diagram for explaining the manner of use of the endoscope 63 and the sheath device 61 in bidirectional vertebral endoscopic surgery.
  • the bidirectional vertebral endoscopic surgery includes a step S1 of marking the positions of the operation hole B and the endoscope hole A, a step of cutting a portion of the marked portion that forms the surgical hole B, (S3) of expanding the operation hole (B) by using the extension tube (11), cutting the skin at the point where the endoscope hole (A) is to be secured (S4)
  • a step S6 of inserting the sheath device 61 with the endoscope camera 63 into the endoscope cavity A a step S7 of injecting saline solution into the surgical site through the sheath
  • a step S8 of removing the sheath device 61 equipped with the endoscope from the endoscope hole A a step S9 of performing the necessary operation through the operation hole B, (S10) of sewing the staple (A).
  • the step (S1) of marking the positions of the surgical hole (B) and the endoscope hole (A) is a step of marking the position of the incision to form the surgical hole and the endoscope hole on the skin of the patient.
  • the surgical hole position incision step S2 is a step of making a cut-out portion enough to insert the extension tube of the minimum diameter vertically above the target point.
  • the step S3 of expanding the operation hole B using the extension tube 11 may be performed by using the first to sixth extension tubes 11a to 11f to secure the operation hole B .
  • the step S4 of cutting the position of the endoscope hole A is a step of cutting the position of the endoscope hole A for inserting the endoscope device 60, And separating the bones and muscles using the muscle separator 13 in order to secure an access path and an operation space for the surgical tool to be used.
  • the endoscope camera is inserted into the endoscope hole after inserting the endoscope camera into the sheath device.
  • the saline solution is injected through the injection port 61c, and the saline solution passes through the guide tube 61a of the sheath device to reach the surgical site .
  • a large number of guide grooves 61p are formed on the inner circumferential surface of the guide tube 61a. Further, the groove portion 61g, protruding portion 61h and side slit 61k are formed at the tip end , The saline solution is subjected to gravity and flows without clogging to reach the desired point.
  • the operation step S8 of inserting the surgical instrument into the surgical hole B is performed in the same manner as in the operation of the above-described two-end retractor, muscle retractor, inhaler, disc washing machine, cage guider, main chip cannula, And the like, depending on the type of operation and the surgical situation.
  • the endoscope apparatus removing step S9 is a step of stopping the infusion of saline solution and withdrawing the endoscope apparatus 60 from the endoscope cavity A.
  • the sealing step S10 is a step of removing the remaining saline and the remnant of the operation space, Thereby sealing the hole B and the endoscope hole A.
  • the manner in which the bidirectional vertebral endoscopic surgery proceeds depends on the need.

Abstract

Linvention concerne un dispositif d'endoscope pour chirurgie spinale endoscopique biportale. Le dispositif comprend : un tube de guidage, qui est un élément en forme de tube creux s'étendant dans la direction longitudinale de celui-ci et ayant une extrémité de pointe pouvant atteindre un site cible dans un corps pendant l'utilisation, le tube de guidage recevant une sonde d'une caméra d'endoscope à l'intérieur de celui-ci ; une partie de guidage de solution saline qui est montée sur l'extrémité arrière du tube de guidage et guide une solution saline injectée depuis l'extérieur dans le tube de guidage ; et une partie d'adaptateur qui est située à l'extrémité arrière du tube de guidage et guide une sonde d'une caméra d'endoscope à utiliser vers le tube de guidage.
PCT/KR2017/013881 2017-11-14 2017-11-30 Dispositif de gaine pour chirurgie spinale endoscopique biportale WO2019098444A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
US16/763,175 US11457909B2 (en) 2017-11-14 2017-11-30 Sheath device for biportal endoscopic spinal surgery

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
KR10-2017-0151636 2017-11-14
KR20170151636 2017-11-14
KR10-2017-0162530 2017-11-30
KR1020170162530A KR102056153B1 (ko) 2017-11-14 2017-11-30 양방향 척추 내시경 수술용 시스장치

Publications (1)

Publication Number Publication Date
WO2019098444A1 true WO2019098444A1 (fr) 2019-05-23

Family

ID=66539028

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/KR2017/013881 WO2019098444A1 (fr) 2017-11-14 2017-11-30 Dispositif de gaine pour chirurgie spinale endoscopique biportale

Country Status (1)

Country Link
WO (1) WO2019098444A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN114305610A (zh) * 2021-12-28 2022-04-12 首都医科大学附属北京友谊医院 一种ube通道建立辅助器械

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP3429536B2 (ja) * 1993-09-30 2003-07-22 オリンパス光学工業株式会社 内視鏡シース
JP3834370B2 (ja) * 1997-01-23 2006-10-18 オリンパス株式会社 内視鏡用洗浄シース
JP2013139790A (ja) * 2012-01-03 2013-07-18 General Electric Co <Ge> 流れフェンスを備えたガスタービンノズル
US20160120395A1 (en) * 2012-09-25 2016-05-05 Tianjin Bolang Science-Technology Development Co. , Ltd. Disposable endoscope sheath
JP2016522707A (ja) * 2013-04-26 2016-08-04 メドトロニック・ゾーメド・インコーポレーテッド 内視鏡レンズ洗浄デバイス

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP3429536B2 (ja) * 1993-09-30 2003-07-22 オリンパス光学工業株式会社 内視鏡シース
JP3834370B2 (ja) * 1997-01-23 2006-10-18 オリンパス株式会社 内視鏡用洗浄シース
JP2013139790A (ja) * 2012-01-03 2013-07-18 General Electric Co <Ge> 流れフェンスを備えたガスタービンノズル
US20160120395A1 (en) * 2012-09-25 2016-05-05 Tianjin Bolang Science-Technology Development Co. , Ltd. Disposable endoscope sheath
JP2016522707A (ja) * 2013-04-26 2016-08-04 メドトロニック・ゾーメド・インコーポレーテッド 内視鏡レンズ洗浄デバイス

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN114305610A (zh) * 2021-12-28 2022-04-12 首都医科大学附属北京友谊医院 一种ube通道建立辅助器械
CN114305610B (zh) * 2021-12-28 2023-06-23 首都医科大学附属北京友谊医院 一种ube通道建立辅助器械

Similar Documents

Publication Publication Date Title
KR20190054857A (ko) 양방향 척추 내시경 수술용 시스장치
US4971036A (en) Vaginal speculum
US5195541A (en) Method of performing laparoscopic lumbar discectomy
US6520907B1 (en) Methods for accessing the spinal column
JP4250647B2 (ja) 組織リトラクター
US8105236B2 (en) Surgical access device, system, and methods of use
ES2394099T3 (es) Aparato para el tratamiento de la estenosis espinal
US5855549A (en) Method of using an optical female urethroscope
ES2352196T3 (es) Dispositivos para cirugía percutánea.
JPH08505070A (ja) 体腟を拡張する検鏡
WO2019098458A1 (fr) Procédé de fonctionnement d&#39;endoscope vertébral bidirectionnel et rasoir diamant utilisé dans celui-ci
US20110245602A1 (en) Flexible endoscope with full-length lumen
WO2019098457A1 (fr) Procédé de fonctionnement d&#39;endoscope vertébral bidirectionnel et ensemble d&#39;outil d&#39;opération utilisé dans celui-ci
KR101441320B1 (ko) 최소 침습 내시경 척추수술을 수행하기 위한 수술도구세트
CN101217915A (zh) 手术入口器械、系统以及使用方法
WO2019098444A1 (fr) Dispositif de gaine pour chirurgie spinale endoscopique biportale
EP3520677A1 (fr) Dispositif de nettoyage de lentille intra-opératoire
WO1995020341A1 (fr) Endoscope avec instrument inserable
JPH1176246A (ja) 外科手術用腔確保具
US20160106300A1 (en) Flexible Endoscopic Exoskeleton Surgical System
CN216021184U (zh) 镜外脊柱手术器械组件
WO2024091003A1 (fr) Module d&#39;élimination d&#39;appareil d&#39;élimination de tissu
Liehn et al. Special Instruments
WO2014058220A2 (fr) Instrument chirurgical laser pour la chirurgie de la colonne vertébrale et procédé associé
CN117045339A (zh) 一种手术护板结构

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 17932200

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 17932200

Country of ref document: EP

Kind code of ref document: A1

32PN Ep: public notification in the ep bulletin as address of the adressee cannot be established

Free format text: NOTING OF LOSS OF RIGHTS PURSUANT TO RULE 112(1) EPC (EPO FORM 1205 DATED 29.01.2021)

122 Ep: pct application non-entry in european phase

Ref document number: 17932200

Country of ref document: EP

Kind code of ref document: A1