WO2023173470A1 - Intubation-type tissue expansion orthopedic minimally invasive surgery tool - Google Patents

Abstract

Provided is an intubation-type tissue expansion orthopedic minimally invasive surgery tool, which belongs to the field of medical instruments, and comprises a solid needle (1), a first hollow sleeve (2), and a second hollow sleeve (3). The tail end of the solid needle (1) is provided with a first buckle matching part (100), and the head end of the solid needle (1) is provided with a first guide structure (101); the first hollow sleeve (2) is used for sleeving the solid needle (1), the tail end of the first hollow sleeve (2) is provided with a second buckle matching part (200) used for being detachably connected to the first buckle matching part (100), and the head end of the first hollow sleeve (2) is provided with a second guide structure (201); the second hollow sleeve (3) is used for sleeving the first hollow sleeve (2), and the head end of the second hollow sleeve (3) is provided with a third guide structure (300). The tool has the beneficial effects that the defects of large scars and even skin necrosis caused by opening a large opening in a traditional open surgery can be avoided.

Description

A cannulated tissue expansion orthopedic minimally invasive surgical tool Technical field

The invention belongs to the field of medical devices, and specifically relates to a cannula-type tissue expansion orthopedic minimally invasive surgical tool.

Background technique

Avulsion fracture of the tibial attachment point of the posterior cruciate ligament of the knee joint is almost the deepest fracture type in the human body. The fracture fragment at this site is far away from the surface skin, and there are a large number of important nerves, blood vessels and their branches distributed in this site. Its surgical treatment is very difficult. The traditional incisional surgery method requires an operating window of at least 6-8 cm in the popliteal fossa, regardless of the type of incision used. There are tibial nerve, popliteal artery, popliteal vein and a large number of their branches in the popliteal fossa. These are risk factors during the operation. Sometimes it is even necessary to cut off part of the gastrocnemius muscle bundle. Even so, there is still a risk during internal fixation. The operating space is narrow and the surgical progress is difficult.

In recent years, there have been a large number of reports on arthroscopic surgery for avulsion fractures of the tibial attachment of the posterior cruciate ligament. This surgery generally requires at least 4 surgical incisions and at least 2 bone tunnels in the tibia. Moreover, the surgery is not completely performed in the natural cavity. It needs to be combined with the posteromedial incision of the knee joint to establish a bone-soft tissue tunnel that does not exist. The actual surgical trauma is no less than that of traditional open surgery. However, arthroscopic operation in the deep popliteal fossa is very difficult and requires very high technical skills from doctors. The operation time is relatively long, the reduction is usually not ideal, the fixation effect is controversial, and postoperative rehabilitation cannot be carried out early.

Based on the above realistic pain points, in order to solve practical clinical needs, the applicant developed a cannulated tissue expansion orthopedic minimally invasive surgical tool through extensive practical experience, which satisfies the needs of minimally invasive surgery that does not use arthroscopy or large incisions. invasive surgery requirements.

Contents of the invention

In order to make up for the shortcomings of the existing technology, the present invention provides a technical solution for a cannula-type tissue expansion orthopedic minimally invasive surgical tool.

An intubation-type minimally invasive orthopedic surgical tool for tissue expansion, including a solid needle, a first hollow cannula and a second hollow cannula. The solid needle is provided with a first snap-fitting part at its tail end and a first guide at its head end. structure, the first hollow sleeve is used to fit outside the solid needle, its tail end is provided with a second buckle fitting part for detachable connection with the first buckle fitting part, and the head end is provided with a second guide structure, so The second hollow casing is used to fit outside the first hollow casing, and a third guide structure is provided at its head end.

Further, the first snap-fitting part is a convex structure provided on the tail end side wall of the solid needle, and the second snap-fitting part is an opening provided on the tail end side wall of the first hollow cannula. structure, the protruding structure is in sliding fit with the opening structure, the opening structure includes an axial section and a circumferential section perpendicular to each other, the axial section is used to guide the protruding structure to the circumferential section, and the circumferential section The segment is used to limit the axial position of the protruding structure.

Further, a handle portion is provided at the tail end of the solid needle. The handle portion is located at the rear end of the first snap-fitting portion, and the outer diameter of the handle portion is the same as the outer diameter of the first hollow sleeve, both of which are larger than the solid needle body. the outer diameter.

Further, the first guide structure is a ball head structure.

Further, the second guide structure and/or the third guide structure are conical structures.

Furthermore, when the solid needle cooperates with the first hollow cannula, the two are allowed to slide under the action of external force without blocking. When there is no external force, friction blocks the sliding without blocking.

Furthermore, when the first hollow casing and the second hollow casing cooperate, the two are allowed to slide under the action of external force without blocking. When there is no external force, friction blocks and does not slide off.

Furthermore, a third hollow casing is included. The third hollow casing is used to fit outside the second hollow casing, and a fourth guide structure is provided at its head end.

Further, the fourth guide structure is a cone-shaped structure.

Further, when the second hollow casing and the third hollow casing cooperate, the two are allowed to slide under the action of external force without blocking. When there is no external force, friction blocks and does not slide off.

Compared with the prior art, the beneficial effects of the present invention include:

1. It avoids the shortcomings of traditional open surgery, which involves making large incisions and leaving large scars and even skin necrosis;

2. Push the nerves and blood vessels outside the scope of surgical operation, greatly reducing the possibility of neurovascular damage;

3. Simplifies the surgical operation, reduces the difficulty of the operation, and makes it easier for orthopedic surgeons to master;

4. This set of tools is designed with blunt tips to avoid stabbing nerves, blood vessels and other soft tissues.

Description of the drawings

Figure 1 is a schematic structural diagram of the present invention when it is packaged in a packaging body;

Figure 2 is a cross-sectional view of the solid needle in the present invention;

Figure 3 is a cross-sectional view of the first hollow casing in the present invention;

Figure 4 is a cross-sectional view of the second hollow casing in the present invention;

Figure 5 is a cross-sectional view of the third hollow casing in the present invention;

Figure 6 is a cross-sectional view of the solid needle and the first hollow cannula in the present invention;

Figure 7 is a cross-sectional view of the first hollow casing and the second hollow casing when mated in the present invention;

Figure 8 is a cross-sectional view of the second hollow casing and the third hollow casing when mated in the present invention;

Figure 9 is a schematic top view of the solid spoon-shaped stripper in the present invention;

Figure 10 is a schematic left structural diagram of the solid spoon-shaped stripper in the present invention.

Detailed ways

In the description of the present invention, it should be understood that the terms "one end", "other end", "outside", "upper", "inside", "horizontal", "coaxial", "center", "end" ", "length", "outer end", etc. indicate the orientation or positional relationship based on the orientation or positional relationship shown in the drawings. They are only for the convenience of describing the present invention and simplifying the description, and do not indicate or imply the device or device referred to. Elements must have a specific orientation, be constructed and operate in a specific orientation and therefore are not to be construed as limitations of the invention.

The rear fork dead center is taken as an example below, and the present invention is further described in conjunction with the accompanying drawings.

Please refer to Figure 1-8. An intubation-type tissue expansion orthopedic minimally invasive surgical tool includes a packaging body 6 and a solid spoon-shaped dissector 5 contained in the packaging body 6, a solid needle 1, and a first hollow cannula 2 , the second hollow sleeve 3 and the third hollow sleeve 4, and the packaging body 6 is a packaging bag or a packaging box.

Continuing to refer to Figures 1, 2, and 6, the solid needle 1 has a handle portion 102 and a first snap-fitting portion 100 at its tail end, a first guide structure 101 at its head end, and the handle portion 102 is located at the rear end of the first snap-fit portion 100. , its outer wall has a mesh structure for anti-slip, and the outer diameter of the handle part 102 is the same as the outer diameter of the first hollow sleeve 2, both are larger than the outer diameter of the solid needle body, and the first snap-fitting part 100 is provided on The convex cylindrical structure on the tail end side wall of the solid needle 1, the first guide structure 101 is preferably a ball head structure.

Further, the solid needle 1 has a total length of 130-160mm, a main body diameter of 2-3mm, and the tail end handle portion 102 is a cylinder with a length of 10-20mm. The outer diameter of the tail end handle portion 102 is the same as the outer diameter of the first hollow sleeve 2. The first The guide structure 101 is a cone-shaped structure that gradually shrinks until the tip becomes a ball head with a diameter of 1.5 mm. The main body 10-20 mm away from the tail end handle has a first snap-fitting part 100. The first snap-fitting part 100 The outer diameter is preferably equal to the outer diameter of the solid needle 1, and the height is equal to the wall thickness of the first hollow sleeve 2.

The function of the solid needle 1 is to mate with the first hollow cannula 2 and form a snap-on integrated structure to jointly enter the soft tissue tunnel. The cone-shaped plus ball head design will not puncture the tissue.

Continuing to refer to Figures 1, 3, 6, and 7, the first hollow sleeve 2 is used to fit outside the solid needle 1, and its tail end is provided with a second snap fit that is detachably connected to the first snap fit portion 100. 200, a second guide structure 201 is provided at the head end, and the second guide structure 201 is a conical structure. Wherein, the second snap-fitting part 200 is an opening structure provided on the side wall of the rear end of the first hollow sleeve 2, and the protruding structure is slidably matched with the opening structure. The opening structure includes a perpendicular axial section 2000 and a circumferential section 2001. The axial section 2000 is used to guide the protruding structure to the circumferential section 2001, and the circumferential section 2001 is used to axially limit the protruding structure.

Further, the total length of the first hollow cannula 2 is 110-140mm, and the inner diameter is preferably just enough to pass through the solid needle 1 (i.e. 2-3mm). That is, when the solid needle 1 is matched with the first hollow cannula 2, the inner diameter of the two can be It is allowed to slide under the action of external force without blocking. When there is no external force, friction blocks and does not slide off. The outer diameter of the first hollow casing 2 is 5-6mm. The tip of the head is conical, and the tail end is an ordinary nozzle. The tip and tail end Polish both the inner and outer openings until they are smooth and round without cutting the soft tissue. In addition, the first hollow casing 2 has an L-shaped gap 10-20mm away from the tail end, which is the second snap-fitting part 200. The depth of the second snap-fitting part 200 reaches the entire casing wall thickness, and the width is just enough to accommodate the solid The columnar protrusion of the needle 1 can just slide in the L-shaped gap. The handle 102 of the solid needle 1 can be manually rotated to bend and lock the buckle (the two are allowed to slide and lock or loosen under the action of external force). When there is no external force, the friction block buckle is locked and does not loosen). When the set of solid needles 1 is fully inserted and buckled into the first hollow sleeve 2, a pencil-shaped structure can be formed, with a tip similar to a pencil tip, a ball tip with a diameter of 1.5mm, a conical tip at the back, and a first hollow tip. The main body of the cannula 2 and the handle portion 102 of the solid needle 1 together form a pencil body.

Continuing to refer to Figures 1, 4, 7, and 8, the second hollow casing 3 is used to fit outside the first hollow casing 2, and a third guide structure 300 is provided at its head end. The third guide structure 300 is a conical structure.

Further, the total length of the second hollow casing 3 is 100-130mm, and the inner diameter is preferably just enough to pass through the first hollow casing 2 (ie 5-6mm), that is, the second hollow casing 3 is connected to the first hollow casing 2. When matched, the two are allowed to slide under the action of external force without blocking. When there is no external force, friction blocks and does not slide down. The outer diameter of the first hollow cannula 2 is 7-8mm, the tip of the head is conical, and the tail end has a normal mouth. The tip and tail end are polished to be smooth and round at the inner and outer openings without cutting the soft tissue. The tail end of the first hollow casing 2 has no gap and is 10 mm shorter than the first hollow casing 2 .

Continuing to refer to Figures 1, 5 and 8, the third hollow casing 4 is used to fit outside the second hollow casing 3, and a fourth guide structure 400 is provided at its head end. The fourth guide structure 400 is a conical structure.

Further, the total length of the third hollow casing 4 is 90-120mm, and the inner diameter is preferably just enough to pass through the second hollow casing 3 (ie 7-8mm), that is, the third hollow casing 4 and the second hollow casing 3 are set When matched, the two are allowed to slide under the action of external force without blocking. When there is no external force, friction blocks and does not slide off. The outer diameter of the third hollow casing 4 is 8-9mm, the tip of the head is conical, and the tail end is an ordinary tube. The mouth, tip and tail are polished at the inner and outer mouth to be smooth and round without cutting the soft tissue. There is no gap at the tail end of the third hollow cannula 4, and it is 10mm shorter than the second hollow cannula 3. The three cannulas are 10mm shorter in order from the smallest to the largest to facilitate grasping when the inner cannula needs to be taken out first during the operation.

Continuing to refer to Figure 1, the solid spoon-shaped peeler 5 has a total length of 140-180mm, a handle length of 100-120mm, a neck length of 20-40mm, a spoon-shaped part length of 20-40mm, a flat handle width of 10-12mm, a thickness of 2-4mm, and a neck length of 20-40mm. It is 2-3mm wide and 2mm thick. The spoon-shaped part is 4mm wide and 3mm thick. The upper and lower sides of the handle end have wavy protrusions. The spoon-shaped part is slightly arc-shaped, and both upper and lower sides have rounded protrusions.

The function of the solid spoon-shaped dissector 5: After the blade cuts the skin, it bluntly separates the subcutaneous soft tissue, and moves away all subcutaneous soft tissues including nerves and blood vessels to form a potential soft tissue cavity tunnel, which provides the solid needle 1 and cannula behind. Enter first to clear the way. The solid spoon-shaped upper and lower sides are designed with rounded protrusions, which will not hurt the tissue. The arc-shaped slightly arched back design is good for evacuating soft tissue. The wavy protrusions on the upper and lower sides of the handle end are convenient for holding and exerting force.

Steps for usage:

Before surgery, first measure the size and relative displacement of the avulsed bone fragment at the tibial attachment point of the posterior cruciate ligament on X-rays and CT films, so that you can be aware of it before surgery (for bone fragments with a diameter less than 10 mm, it is recommended to use this method with caution. Invention, recommended for fracture types with bone fragments larger than 10 mm in diameter and not severely reversed). After successful anesthesia, the patient should be placed in a prone position, and the ankle should be elevated appropriately to make the knee joint slightly flexed to reduce the tension and resistance of the skin and soft tissue of the popliteal fossa and neuromuscular tendon. Before formal scalpel cutting, use the cross-body surface Kirschner wire method to locate the body surface projection position of the fracture fragment under C-arm X-ray fluoroscopy. The blade makes a small incision at a position 5-8cm cephalad to the projection of the bone surface, with a length no more than 10mm. Use the solid spoon-shaped dissector 5 to bluntly separate the subcutaneous soft tissue, especially push away the potential nerves and blood vessels, and open up a relatively deep but relatively small soft tissue channel, which reaches directly to the back and upper part of the fracture fragment, and confirm it with an X-ray fluoroscopy machine The dissector reaches the posterior and superior aspect of the fracture fragment. Exit the dissector, assemble and lock the solid needle 1 and the first hollow cannula 2, enter from the back and top of the popliteal fossa along the opened soft tissue channel, directly to the back and top of the bone fragment, and use an X-ray fluoroscopy machine to confirm that the fracture fragment is found . When the C-arm machine fluoroscopically confirms that the ball head of the tip of solid needle 1 has found and reached the upper and posterior bone surface of the fracture fragment, press the bone fragment forward and downward roughly perpendicular to the bone surface (this is the reduction action) and against the bone fragment. Rotate the handle part 102 of the solid needle 1 (release the previously locked buckle), and withdraw the solid needle 1. Insert a planned hollow screw guide pin into the inner diameter channel of the first hollow casing 2. C-arm machine fluoroscopy confirms that the fracture fragment is accurately penetrated by the guide pin and fixed at the original fracture avulsion position of the posterior slope between the tibial plateau and condyles. Correct. Exit the first hollow cannula 2, turn it around, and insert the blunt end downwards into the guide pin again. Then insert the second hollow casing 3 with the tapered head facing downward. If the insertion is not smooth enough, do not use brute force. Exit the second hollow casing 3 appropriately, and then surround the first hollow casing with a solid spoon-shaped stripper. A secondary soft tissue release is performed around the tube 2, and the second hollow cannula 3 is inserted again. Exit the first hollow casing 2, retain the second hollow casing 3, use the hollow nail opening electric drill bit to electrically open the hole in the direction of the guide needle under the protection of the second hollow casing 3, withdraw the opening electric drill bit, and take a suitable hollow nail. The semi-threaded screw is screwed in along the direction of the guide pin and fixes the fracture fragment. Keep the guide pin and exit the screwdriver. C-arm machine fluoroscopy verifies that the fracture fragment is properly fixed and the screw length is appropriate before removing the guide pin. If the fracture fragment is large enough to allow the second or even third cannulated screw to be screwed in, continue to drive the second and third cannulated screws in this manner. If the fracture fragment is small enough to screw in only one screw, the operation is over and the fracture is flushed and sutured. If the fracture is small, only one stitch or intradermal suturing is required. Most of the hollow screw tail caps are between 3.5-4.5mm. In the end, only using the second hollow sleeve 3 (inner diameter 5-6mm) is enough to allow the screws to pass. There is no need to use the third hollow sleeve 4, only at the screw tail. The third hollow sleeve 4 is only needed when the cap needs to be used with a washer (diameter 6.5mm). The use of the third hollow sleeve 4 is the same as the second hollow sleeve 3. Just pay attention to one thing. Once the washer is put into the third hollow sleeve with the screw, The hollow casing cannot be exited again within the 4th channel, so use it with caution and don't regret it.

Finally, it should be noted that the above embodiments are only used to illustrate the technical solution of the present invention, but not to limit it. Although the present invention has been described in detail with reference to the foregoing embodiments, those of ordinary skill in the art should understand that: The technical solutions described in the foregoing embodiments can still be modified, or some or all of the technical features can be equivalently replaced; and these modifications or substitutions do not deviate from the essence of the corresponding technical solutions from the technical solutions of the embodiments of the present invention. scope.

Claims (10)

1. An intubation-type minimally invasive orthopedic surgical tool for tissue expansion, characterized by comprising a solid needle (1), a first hollow cannula (2) and a second hollow cannula (3). The solid needle (1) A first snap fitting part (100) is provided at the tail end, and a first guide structure (101) is provided at the head end. The first hollow sleeve (2) is used to fit outside the solid needle (1), and its tail end is provided with The second snap-fit part (200) is used for detachable connection with the first snap-fit part (100). A second guide structure (201) is provided at the head end. The second hollow sleeve (3) is used to cover the second snap-fit part (200). It is arranged outside the first hollow casing (2), and its head end is provided with a third guide structure (300).
2. A cannula-type tissue expansion orthopedic minimally invasive surgical tool according to claim 1, characterized in that the first snap-fitting part (100) is provided on the tail end side wall of the solid needle (1). The convex structure, the second snap-fitting part (200) is an opening structure provided on the rear end side wall of the first hollow casing (2), the convex structure is slidingly matched with the opening structure, and the opening structure includes a corresponding A vertical axial section (2000) and a circumferential section (2001), the axial section (2000) is used to guide the protruding structure to the circumferential section (2001), the circumferential section (2001) is used to To limit the axial position of the raised structure.
3. An intubation-type minimally invasive orthopedic surgical tool for tissue expansion according to claim 1, characterized in that a handle portion (102) is provided at the tail end of the solid needle (1), and the handle portion 102 is located on the first clamp. The rear end of the fitting part (100) is buckled, and the outer diameter of the handle part (102) is larger than the outer diameter of the solid needle body.
4. A cannula-type tissue expansion orthopedic minimally invasive surgical tool according to claim 1, characterized in that the first guide structure (101) is a ball head structure.
5. A cannula-type minimally invasive orthopedic surgical tool for tissue expansion according to claim 1, characterized in that the second guide structure (201) and/or the third guide structure (300) are conical structures.
6. A cannula-type minimally invasive orthopedic surgical tool for tissue expansion according to claim 1, characterized in that when the solid needle (1) cooperates with the first hollow cannula (2), external force is allowed between the two. It slides without blocking under action, and friction blocks without sliding when there is no external force.
7. An intubation-type minimally invasive orthopedic surgical tool for tissue expansion according to claim 1, characterized in that when the first hollow cannula (2) and the second hollow cannula (3) cooperate, there is a gap between the two. It is allowed to slide under the action of external force without blocking, and it is blocked by friction without sliding when there is no external force.
8. An intubation-type minimally invasive orthopedic surgical tool for tissue expansion according to any one of claims 1 to 7, characterized in that it also includes a third hollow cannula (4), the third hollow cannula (4) It is used to fit outside the second hollow casing (3), and a fourth guide structure (400) is provided at its head end.
9. A cannula-type minimally invasive orthopedic surgical tool for tissue expansion according to claim 8, characterized in that the fourth guide structure (400) is a cone-shaped structure.
10. An intubation-type minimally invasive orthopedic surgical tool for tissue expansion according to claim 8, characterized in that when the second hollow cannula (3) and the third hollow cannula (4) cooperate, both It is allowed to slide under the action of external force without blocking, and friction block will not slide when there is no external force.

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