阅读说明：本技术 一种脊柱微创用全密闭式水媒椎间盘镜操作套管及系统 (Fully-closed water-medium intervertebral disc scope operating sleeve and system for spinal minimally invasive surgery ) 是由 马超 刘光旺 吴晓东 戴尅戎 刘珅 曲新华 高娟 王振飞 孟庆芳 陈涛 黄森 于 2020-06-11 设计创作，主要内容包括：本发明公开了一种脊柱微创用全密闭式水媒介椎间盘镜操作套管及系统,包括管体,所述管体上固定进排水组件；所述进排水组件用于向管体内进水和排水；进排水组件包括进水管、进水口、排水管、排水口所述进水管固定在管体上,进水管底端与管体底部连通,距离管体底边3-8mm,进水管与管体连通处与管体内壁相切形成进水口；所述排水管固定在管体上,排水管底端与管体顶部连通,连通处距离管体顶边6-12mm,排水管与管体连通处与管体内壁相切形成排水口。该装置具有较大的操作自由度和清晰的操作视野。(The invention discloses a totally-enclosed water medium intervertebral disc scope operating sleeve and a system for spinal minimally invasive surgery, which comprise a pipe body, wherein a water inlet and drainage assembly is fixed on the pipe body; the water inlet and outlet assembly is used for water inlet and water outlet in the pipe body; the water inlet and drainage assembly comprises a water inlet pipe, a water inlet, a drainage pipe and a drainage outlet, wherein the water inlet pipe is fixed on the pipe body, the bottom end of the water inlet pipe is communicated with the bottom of the pipe body and is 3-8mm away from the bottom edge of the pipe body, and the water inlet is formed by the contact of the communication part of the water inlet pipe and the pipe body and the inner wall; the water discharge pipe is fixed on the pipe body, the bottom end of the water discharge pipe is communicated with the top of the pipe body, the distance between the communicated position and the top edge of the pipe body is 6-12mm, and the communicated position of the water discharge pipe and the pipe body is tangent to the inner wall of the pipe body to form a water discharge outlet. The device has larger operation freedom and clear operation visual field.)

1. A totally-enclosed type aqueous medium intervertebral disc scope operating sleeve for minimally invasive spinal column comprises a tube body 10 and is characterized in that,

a water inlet and outlet assembly is fixed on the pipe body;

the water inlet and outlet assembly is used for water inlet and water outlet in the pipe body;

the water inlet and drainage component comprises a water inlet pipe, a water inlet, a water outlet pipe and a water outlet

The water inlet pipe is fixed on the pipe body, the bottom end of the water inlet pipe is communicated with the bottom of the pipe body and is 3-8mm away from the bottom edge of the pipe body, and the communicated part of the water inlet pipe and the pipe body is tangent to the inner wall of the pipe body to form a water inlet;

the water discharge pipe is fixed on the pipe body, the bottom end of the water discharge pipe is communicated with the top of the pipe body, the distance between the communicated position and the top edge of the pipe body is 6-12mm, and the communicated position of the water discharge pipe and the pipe body is tangent to the inner wall of the pipe body to form a water discharge outlet.

2. The totally enclosed aqueous medium diskoscope operating cannula for minimally invasive spinal surgery of claim 1, further comprising a top cover for sealing a top surface of the tube body while providing access for operating instruments to enter the cannula;

the top cover comprises a fixing part, a top film, a first inlet and a second inlet;

the fixing part is used for sealing and fixing the top cover and the pipe body, is cylindrical and can be detachably sealed and fixed with the fixing part of the pipe body;

the top film is used for sealing the top opening of the tube body, a plurality of inlets are fixedly arranged on the top film, and the top film is a rubber film;

the inlet is used as a passage for the endoscope and the operation instrument to enter the tube body;

the inner diameter of the inlet is smaller than the outer diameter of the inner diameter mirror and the outer diameter of the part of the operation instrument extending into the tube body.

3. The minimally invasive spinal fully-enclosed waterborne diskoscope manipulation sleeve of claim 1, wherein the inlet comprises a first inlet;

the first inlet is used as a channel for the endoscope to enter the tube body;

the first inlet comprises a guide pipe, the guide pipe comprises a hard part and an elastic part, and the elastic part is fixed at the bottom end of the hard part;

the hard part extends into the lower side of the top film by 3-5mm, and the inner diameter of the hard part is slightly larger than the outer diameter of the part of the endoscope extending into the tube body;

the top end of the elastic part is communicated with the hard part, the inner diameter of the top end of the elastic part is the same as that of the hard part, and the inner diameter of the bottom end of the elastic part is smaller than the outer diameter of the part, extending into the tube body, of the endoscope.

4. The minimally invasive spinal fully-enclosed waterborne diskoscope manipulation sleeve of claim 1, wherein the inlet comprises a second inlet;

the second inlet is used as a passage for the operating instrument to enter the tube body;

the second inlet comprises hard sheets and an elastic tube, the hard sheets are plastic sheets, parts of the hard sheets are fixedly connected with the elastic tube, the hard sheets are arranged in a staggered mode and partially overlapped with the adjacent hard sheets, and the hard sheets are fully distributed on the inner wall of the elastic tube;

the second inlet extends at least 1/3 below the top film;

and the top end of the part of the top film is fixed with a sealing sleeve.

5. The minimally invasive spinal fully-enclosed waterborne diskoscope manipulation sleeve of claim 1,

the sleeve is made of soft materials and is used for forming a tightly attached boundary when the sleeve is abutted against the spine and human tissues;

the bottom sleeve is annular and coaxial with the pipe sleeve, and the maximum axial length is 15 mm.

6. The minimally invasive spinal fully-enclosed waterborne diskoscope manipulation sleeve of claim 5,

the bottom sleeve comprises an annular inner bottom sleeve and an annular outer bottom sleeve;

the axial length of the inner bottom sleeve is 6-9mm, and the axial length of the outer bottom sleeve is 15 mm;

a gap of 2-5mm is formed between the inner bottom sleeve and the outer bottom sleeve;

also comprises an air suction pipe and an air guide ring;

the bottom end of the air suction pipe is communicated with the air entraining ring, the air entraining ring is fixed on the bottom edge of the pipe sleeve, and the bottom surface of the air suction pipe is provided with an annular air entraining through groove;

the air-entraining through groove of the air-entraining ring is positioned between the inner bottom sleeve and the outer bottom sleeve, and the top surfaces of the inner bottom sleeve and the outer bottom sleeve are hermetically and fixedly connected with the bottom surface of the air-entraining ring or the two inner and outer ring surfaces, so that the air-entraining groove can suck gas or liquid between the inner bottom sleeve and the outer bottom sleeve;

the suction pipe is used to suck gas or a small amount of liquid.

7. The totally enclosed waterborne intervertebral disc scope operating sleeve for minimally invasive spinal surgery of claim 1, further comprising a sidewall sleeve for forming a sealed environment between an outer side surface of the sleeve and an inner wall of the wound;

the side wall sleeve set comprises a sleeve film, an air bag, an air inlet pipe and an air inlet ring;

the covering film is cylindrical and is sleeved on the outer wall of the bottom of the tube body, and the inner wall of the covering film is tightly attached to the outer wall of the tube body;

the covering film is fixed with a plurality of air bags which are annular air bags;

the maximum outer diameter of the inflated air bag is 1.1-1.25 times of the outer diameter of the pipe body;

the air inlet pipe is communicated with the air bag and used for pumping air in the air bag.

8. The minimally invasive totally closed waterborne media spinal disc scope operating sleeve as claimed in any one of claims 1 to 7, wherein the tube body is in the shape of an inverted frustum with a top opening diameter 1.2 to 1.8 times the diameter of a bottom opening.

9. A totally closed waterborne intervertebral disc scope operation system for minimally invasive spinal column, which is characterized by comprising the totally closed waterborne intervertebral disc scope operation sleeve for minimally invasive spinal column according to claims 1 to 8.

10. The totally enclosed waterborne diskoscope manipulation system for minimally invasive spinal procedures of claim 9, further comprising an endoscope, a bracket for detachably securing the endoscope to the tube housing, and a manipulation bracket for positioning the tube housing relative to the wound site.

Technical Field

The invention relates to a large-channel full-view intervertebral disc mirror body and a sleeve used for minimally invasive spine surgery, an imaging and light source system with the sleeve, in particular to a large-diameter working sleeve.

Background

Minimally invasive spine surgery is increasingly not separated from imaging endoscope systems. Existing spinal endoscopes include a discoscope and an foraminoscopy.

The principle of the discoscope operation is as follows: the working cannula is placed into the intervertebral disc, a portion of the vertebral lamina is removed under direct vision with the endoscope, the nerve root is exposed, the herniated nucleus pulposus tissue is removed, the incision is about 1.8 cm, and the endoscope lens is inserted into the cannula during operation and is fixed at the top end of the cannula to provide a stable visual field. The mode has the great disadvantage that the blood of the wound easily stains the lens by taking air as a medium, so that the visual field is not clear, and the operation is required to be suspended to clean the wound. The advantages are that: the operation space is large, and especially, various tools can enter the wound without limitation basically, so that the difficulty of the operation can be reduced. The reasonable utilization support, single operation space is bigger, the operation of being convenient for, to executing the operation person, only need consider the problem of operation, need not help the hand to hold the endoscope basically.

Intervertebral foramen mirror operation principle: the working cannula is passed through a small incision from a safe area behind or behind the patient's body into the intervertebral foramen or the intervertebral disc space, and a coaxial endoscope is placed from the working cannula to perform the procedure around the disc herniation. Its advantages are use of water as medium, clear visual field, and no pollution to lens. The defect is that the instrument channel is only 3-5mm, the operation space is small, and a conventional decompression fusion large-size tool cannot be placed under the direct vision of an endoscope.

Some patients with herniated intervertebral disc and spinal stenosis merge spinal instability, and pure decompression is not enough, and at the moment, fusion is required to be fixed, the existing under-mirror intervertebral fusion device is not placed under full-visible endoscope, but is placed under C-arm X-ray fluoroscopy, and the nerve dura mater sac is not developed under X-ray fluoroscopy, so that whether key tissues such as the nerve dura mater sac can be damaged in the operation or not can not be monitored.

Therefore, it is critical to ensure that the large endoscope sleeve is placed into a conventional open surgical tool, the intervertebral fusion cage is safely and minimally invasively placed, and a clear surgical view can be ensured.

Disclosure of Invention

The embodiment of the application solves the problem that a large-channel inner-diameter sleeve cannot provide a clear operation visual field in the prior art by providing the fully-closed water-medium intervertebral disc scope operation sleeve and the system for spinal minimally invasive surgery.

The embodiment of the application provides a totally-enclosed type water media intervertebral disc scope operating sleeve for spinal column minimally invasive surgery, which comprises a pipe body,

a water inlet and outlet assembly is fixed on the pipe body;

the water inlet and outlet assembly is used for water inlet and water outlet in the pipe body;

the water inlet and drainage component comprises a water inlet pipe, a water inlet, a water outlet pipe and a water outlet

The water inlet pipe is fixed on the pipe body, the bottom end of the water inlet pipe is communicated with the bottom of the pipe body and is 3-8mm away from the bottom edge of the pipe body, and the communicated part of the water inlet pipe and the pipe body is tangent to the inner wall of the pipe body to form a water inlet;

the water discharge pipe is fixed on the pipe body, the bottom end of the water discharge pipe is communicated with the top of the pipe body, the distance between the communicated position and the top edge of the pipe body is 6-12mm, and the communicated position of the water discharge pipe and the pipe body is tangent to the inner wall of the pipe body to form a water discharge outlet.

The top cover is used for sealing the top surface of the tube body and simultaneously providing an inlet for an operating instrument to enter the sleeve;

the top cover comprises a fixing part, a top film, a first inlet and a second inlet;

the fixing part is used for sealing and fixing the top cover and the pipe body, is cylindrical and can be detachably sealed and fixed with the fixing part of the pipe body;

the top film is used for sealing the top opening of the tube body, a plurality of inlets are fixedly arranged on the top film, and the top film is a rubber film;

the inlet is used as a passage for the endoscope and the operation instrument to enter the tube body;

the inner diameter of the inlet is smaller than the outer diameter of the inner diameter mirror and the outer diameter of the part of the operation instrument extending into the tube body.

Further, the inlet comprises a first inlet;

the first inlet is used as a channel for the endoscope to enter the tube body;

the first inlet comprises a guide pipe, the guide pipe comprises a hard part and an elastic part, and the elastic part is fixed at the bottom end of the hard part;

the hard part extends into the lower side of the top film by 3-5mm, and the inner diameter of the hard part is slightly larger than the outer diameter of the part of the endoscope extending into the tube body;

the top end of the elastic part is communicated with the hard part, the inner diameter of the top end of the elastic part is the same as that of the hard part, and the inner diameter of the bottom end of the elastic part is smaller than the outer diameter of the part, extending into the tube body, of the endoscope.

Further, the inlet comprises a second inlet;

the second inlet is used as a passage for the operating instrument to enter the tube body;

the second inlet comprises hard sheets and an elastic tube, the hard sheets are plastic sheets, parts of the hard sheets are fixedly connected with the elastic tube, the hard sheets are arranged in a staggered mode and partially overlapped with the adjacent hard sheets, and the hard sheets are fully distributed on the inner wall of the elastic tube;

the second inlet extends at least 1/3 below the top film;

and the top end of the part of the top film is fixed with a sealing sleeve.

The sleeve is made of soft materials and is used for forming a tightly attached boundary when the sleeve is abutted against the spine and human tissues;

the bottom sleeve is annular and coaxial with the pipe sleeve, and the maximum axial length is 15 mm.

Further, the bottom cover comprises an annular inner bottom cover and an annular outer bottom cover;

the axial length of the inner bottom sleeve is 6-9mm, and the axial length of the outer bottom sleeve is 15 mm;

a gap of 2-5mm is formed between the inner bottom sleeve and the outer bottom sleeve;

also comprises an air suction pipe and an air guide ring;

the bottom end of the air suction pipe is communicated with the air entraining ring, the air entraining ring is fixed on the bottom edge of the pipe sleeve, and the bottom surface of the air suction pipe is provided with an annular air entraining through groove;

the air-entraining through groove of the air-entraining ring is positioned between the inner bottom sleeve and the outer bottom sleeve, and the top surfaces of the inner bottom sleeve and the outer bottom sleeve are hermetically and fixedly connected with the bottom surface of the air-entraining ring or the two inner and outer ring surfaces, so that the air-entraining groove can suck gas or liquid between the inner bottom sleeve and the outer bottom sleeve;

the suction pipe is used to suck gas or a small amount of liquid.

The wound protection sleeve further comprises a side wall sleeve group, wherein the side wall sleeve group is used for forming a sealed environment between the outer side face of the sleeve and the inner wall of the wound;

the side wall sleeve set comprises a sleeve film, an air bag, an air inlet pipe and an air inlet ring;

the covering film is cylindrical and is sleeved on the outer wall of the bottom of the tube body, and the inner wall of the covering film is tightly attached to the outer wall of the tube body;

the covering film is fixed with a plurality of air bags which are annular air bags;

the maximum outer diameter of the inflated air bag is 1.1-1.25 times of the outer diameter of the pipe body;

the air inlet pipe is communicated with the air bag and used for pumping air in the air bag.

Furthermore, the pipe body is in an inverted frustum shape, and the diameter of the opening at the top end is 1.2-1.8 times that of the opening at the bottom end.

A totally closed waterborne intervertebral disc scope operating system for minimally invasive spinal column, comprising the totally closed waterborne intervertebral disc scope operating sleeve for minimally invasive spinal column according to claims 1 to 8.

The medical endoscope also comprises an endoscope, a bracket for detachably fixing the endoscope and the pipe sleeve, and an operation bracket for positioning the pipe sleeve relative to the wound position.

One or more technical solutions provided in the embodiments of the present application have at least the following technical effects or advantages:

because the water inlet and the water discharge device are adopted, the water is used as a medium, the blood of the wound can be quickly diluted and washed, and a clear visual field is provided for the endoscope.

Drawings

FIG. 1 is a schematic structural diagram of the present application;

fig. 2 is a schematic view of an inner bottom ring structure.

Figure 3 is a schematic view of the cannula in use.

Figure 4 is a schematic view of a discoscope system.

Fig. 5 is a schematic structural view when the sleeve is a taper pipe.

Fig. 6 is a schematic view of the structure of the inner wall of the second inlet.

In the figure, a tube body 10, a bottom cover 20, an inner bottom cover 21, an outer bottom cover 22, a side wall sleeve set 30, a sleeve film 31, an air bag 32, an air inlet pipe 33, an air inlet ring 34, an air suction pipe 40, an air bleed ring 41, an air inlet and water outlet assembly 50, a water inlet pipe 51, a water inlet 511, a water outlet pipe 52, a water outlet 521, a top cover 60, a first inlet 61, a second inlet 62 and an endoscope 70.

Detailed Description

To facilitate an understanding of the invention, the invention will now be described more fully with reference to the accompanying drawings. Preferred embodiments of the present invention are shown in the drawings. This invention may, however, be embodied in many different forms and should not be construed as limited to the embodiments set forth herein. Rather, these embodiments are provided so that this disclosure will be thorough and complete.

It will be understood that when an element is referred to as being "secured to" another element, it can be directly on the other element or intervening elements may also be present. When an element is referred to as being "connected" to another element, it can be directly connected to the other element or intervening elements may also be present. The terms "vertical," "horizontal," "left," "right," and the like as used herein are for illustrative purposes only and do not represent the only embodiments.

Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. The terminology used herein in the description of the invention is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. As used herein, the term "and/or" includes any and all combinations of one or more of the associated listed items.

The device for water inlet and outlet is added in the pipe sleeve 10, the pipe sleeve 10 or an operation area is filled with water, the water is used as a medium, and air is not used as a visual field medium. Therefore, the wound is bleeding, can be quickly diluted and discharged by water, cannot stain the lens of the endoscope, and keeps a good visual field.