A real-time bone removal trephine with scale visualization for spinal endoscopy

Abstract

Disclosed is a real-time bone removal ring saw with endoscopic scale visualization for the spine, which comprises a protective sleeve, a saw body, a spinal endoscope and a bone removal amount calculation device; the protective sleeve comprises a hollow tube body, one end of the hollow tube body is arranged in the form of an inclined surface, and the other end is provided with a first handle, the first handle is provided with a first through hole connected to the hollow tube body, the saw body comprises a hollow saw body main part, one end of the hollow saw body main part is provided with saw teeth and the other end is provided with a second handle, the second handle is provided with a second through hole connected to the hollow saw body main part, wherein the hollow saw body main part is arranged in the hollow tube body via the first through hole, and the spinal endoscope is arranged in the hollow saw body main part via the second through hole; and the bone removal amount calculation device calculates one or more of the bone removal area, bone removal depth and bone removal volume.

Description

Technical Field

[0001] The invention relates to the field of medical technology, and in particular to a real-time bone removal trephine with visualized endoscopic scales of the spine. Background Art

[0002] Lumbar disc herniation and lumbar spinal stenosis are the main causes of back pain in many patients. These symptoms can be relieved to a certain extent through conservative treatment, such as bed rest, taking anti-inflammatory drugs, receiving physical therapy or injecting steroids. However, these basic treatments are ineffective for some patients. Patients still suffer great pain from back pain and cannot carry out daily activities normally. Some may even develop chronic low back pain. Surgical treatment is another option for treating these symptoms. Spinal endoscopy, as a minimally invasive surgery, has gradually gained attention and popularity in my country in recent years due to its characteristics of small trauma, fast recovery, visual safety, and relatively low cost. The surgical target is often located in the spinal canal and surrounded by hard bony structures. Therefore, bone removal to establish a working channel or decompression becomes the primary prerequisite for spinal endoscopic surgery. Existing spinal endoscopic bone removal tools are power grinding drills, ultrasonic bone knives, traditional bone drills, blind trephine saws, and endoscopic trephine saws. However, traditional bone drills and blind trephine saws cannot be observed in real time, are prone to damage nerve roots and dura mater sac, and are more difficult for beginners to master; powered burrs and ultrasonic bone knives are very expensive and have limited popularity; in contrast, endoscopic trephine saws are inexpensive and are also very safe and effective.

[0003] However, the handle of the existing endoscopic trephine is not conducive to the palm of the hand holding and exerting force, and there are problems such as the bone removal depth and bone removal amount cannot be accurately measured. Therefore, it is necessary to invent a real-time bone removal trephine with endoscopic scale visualization to solve the above problems. Summary of the invention

[0004] According to one aspect of the present invention, a real-time bone removal ring saw with endoscopic scale visualization is provided, which includes a protective sleeve, a saw body, a spinal endoscope and a bone removal amount calculation device; the protective sleeve includes a hollow tube body, one end of the hollow tube body is set in the form of an inclined surface, and the other end is provided with a first handle, the first handle is provided with a first through hole connected to the hollow tube body, the saw body includes a hollow saw body main part, one end of the hollow saw body main part is provided with saw teeth and the other end is provided with a second handle, the second handle is provided with a second through hole connected to the hollow saw body main part, wherein the hollow saw body main part is arranged in the hollow tube body via the first through hole, and the spinal endoscope is arranged in the hollow saw body main part via the second through hole; and the bone removal amount calculation device calculates one or more of the bone removal area, bone removal depth and bone removal volume.

[0005] The spinal endoscopic scale-visualized real-time bone removal ring saw according to the present invention has a simple structure, efficient and safe operation, and can observe the bone removal depth of the ring saw in real time with the naked eye without adding a fluoroscopic device and radiation, providing objective data support, avoiding excessively deep nerve damage and disorientation due to dorsal operation.

[0006] Further features of the present invention will become apparent from the following description of exemplary embodiments with reference to the attached drawings. BRIEF DESCRIPTION OF THE DRAWINGS

[0007] Figure 1 The figure is a schematic diagram of the overall configuration of a real-time bone removal trephine with spinal endoscopy scale visualization according to an embodiment of the present invention.

[0008] Figure 2 Schematic diagram of the structure of a protective cover according to an embodiment of the present invention.

[0009] Figure 3 Schematic diagram of the structure of a saw body according to an embodiment of the present invention.

[0010] Figure 4 FIG. 4 is a schematic diagram of an enlarged structure of a sawtooth according to an embodiment of the present invention.

[0011] Figure 5 Schematic diagram of the structure of a saw body according to an embodiment of the present invention.

[0012] Figure 6 For the present invention Figure 5 Schematic diagram of the enlarged structure at B.

[0013] Figure 7 Schematic diagram of calculating bone cutting area and bone removal amount according to an embodiment of the present invention.

[0014] In the figure: 1, protective sleeve; 2, saw body; 3, inclined surface; 4, first handle; 5, first through hole; 6, saw teeth; 7, second handle; 8, second through hole; 9, annular depth scale; 10, longitudinal axis area scale; 11, friction-increasing hole. DETAILED DESCRIPTION

[0015] The invention provides a real-time bone removal trephine with endoscopic scale visualization and simple structure, efficient and safe operation.

[0016] Hereinafter, exemplary embodiments of the present invention will be described with reference to the accompanying drawings, but it should be understood that the following embodiments are merely exemplary and are not intended to limit the present invention to these embodiments. In addition, the size, material, shape, relative arrangement, etc. of the constituent elements described in the embodiments may be appropriately changed according to the configuration of the device to which the present invention is applied, various conditions, etc. Therefore, the size, material, shape, relative arrangement, etc. of the constituent elements described in the embodiments are not intended to limit the scope of the present invention to the following embodiments.

[0017] Overall configuration

[0018] First, refer to Figure 1 , describing the overall configuration of the real-time bone removal trephine with spinal endoscopic scale visualization according to the present invention.

[0019] The real-time bone removal ring saw with endoscopic scale visualization according to the present invention comprises a protective sleeve 1, a saw body 2, a spinal endoscope and a bone removal amount calculation device. The protective sleeve 1 and the saw body 2 are both configured as hollow structures, the protective sleeve 1 is sleeved on the outside of the saw body 2 to protect the saw body 2, and the saw teeth of the saw body 2 are used to cut the bones to be removed from the human body to achieve the purpose of bone removal. In addition, the spinal endoscope is set in the saw body 2 to observe the bones to be removed, and the bone removal amount calculation device is used to calculate and monitor the bone area and bone volume removed, providing early warning and assistance for the bone removal operation.

[0020] Hereinafter, various components of the real-time bone removal trephine with scale visualization through spinal endoscopy according to the present invention will be described in detail with reference to the accompanying drawings.

[0021] Protective sleeve

[0022] refer to Figure 2 , describing the protective sleeve 1 according to the present invention. Figure 2 As shown, the protection sleeve 1 according to the present invention comprises a hollow tube body, one end of which is arranged in the form of an inclined surface, and the other end is provided with a handle, and the handle is provided with a through hole communicating with the hollow tube body.

[0023] The hollow tube body is, for example, in the shape of a hollow cylinder, and the inner diameter of the hollow cylinder is, for example, 8 mm, and the outer diameter is, for example, 10 mm. The length of the hollow tube body can be, for example, 20 cm, 30 cm or other suitable lengths, and can be configured as a retractable structure to be suitable for different use environments or different types of trepans. The shape of the cross-section of the hollow tube body is not limited to a cylindrical shape, and can be, for example, a rectangular, trapezoidal, rhombus or irregular shape. However, in order to facilitate the fixing of the protective sleeve in place, it is preferred to configure the hollow tube body as a hollow cylinder.

[0024] In addition, weight-reducing holes, weight-reducing grooves and other structures may be provided on the side wall of the hollow tube to reduce the overall weight of the protective sleeve 1. The hollow tube may be formed of stainless steel, titanium, titanium alloy or a combination thereof.

[0025] One end of the hollow tube body according to the present invention is set in the form of an inclined surface 3 for abutting against a bone surface such as a patient's articular process, vertebral plate, etc. The inclined surface 3 can take various forms. For example, in the projection direction parallel to the inclined surface 3, the inclined surface 3 can be projected as a straight line, a quadratic curve or other curve forms. In the case of being projected as a straight line, it is equivalent to cutting the hollow tube body in a direction that is at an angle to the axis of the hollow tube body. The angle is, for example, 20 degrees, 30 degrees, 45 degrees or other angles. At this time, a sharp top of the inclined surface will be formed. In the case of being projected as a curve, for example, the top of the inclined surface can be made into an arc of a certain length instead of a point. In this way, the safety of the protective sleeve 1 can be increased.

[0026] The other end of the hollow tube body according to the present invention is provided with a handle. The handle is fixedly connected to the hollow tube body, and the hollow tube body is rotated by the handle to make the inclined surface 3 abut against the articular process bone surface. The handle can be, for example, a T-shaped handle, a hemispherical handle or a handle of other shapes. A through hole is provided in the handle to communicate with the cavity of the hollow tube body. Specifically, the through hole can be arranged along the direction of the cavity of the hollow tube body. Alternatively, the hollow tube body can be inserted into the through hole in the handle.

[0027] The cavity of the hollow tube and the through hole provided in the handle are integrally used to accommodate the saw body to be described later. That is, the saw body is arranged inside the protective sleeve 1 through the cavity of the hollow tube and the through hole provided in the handle to protect the saw body.

[0028] Saw body

[0029] refer to Figure 3 , describing a saw body 2 according to the invention.

[0030] The saw body 2 according to the present invention comprises a hollow saw body main part, one end of which is provided with saw teeth and the other end of which is provided with a handle, wherein the handle is provided with a through hole communicating with the hollow saw body main part.

[0031] Similar to the hollow tube, the saw body main part can be configured as a hollow cylindrical shape. In this case, the inner diameter of the hollow cylindrical shape is, for example, 6 mm, and the outer diameter is, for example, 8 mm, to match the inner diameter of the hollow tube. In the case where the cross-section of the saw body main part and / or the hollow tube is configured as, for example, a rectangular, trapezoidal, rhombus or irregular shape, the saw body main part should be configured to be rotatable in the hollow tube.

[0032] One end of the hollow saw body is provided with saw teeth to achieve the removal of the bone surface. Figure 4, which shows an example of a saw body 6 according to an embodiment of the present invention. The saw teeth 6 shown are composed of, for example, 10 teeth, and the 10 teeth are arranged around one end of the main body of the saw body, the height of each tooth is, for example, set to 1 mm, and the distance between adjacent teeth is, for example, set to 1.5 mm. During operation, the saw teeth 6 are close to the bone surface to achieve resection of the bone surface.

[0033] The other end of the hollow saw body main part is provided with a handle, which is fixedly connected to the saw body main part. The handle can be, for example, a T-shaped handle, a hemispherical handle or a handle of other shapes. A through hole is provided in the handle to communicate with the cavity of the hollow saw body main part. Specifically, the through hole can be arranged along the cavity direction of the hollow saw body main part. Alternatively, the hollow saw body main part can be inserted into the through hole in the handle.

[0034] Preferably, the handle included in the saw body 2 is configured as a hemispherical handle 7 to increase the contact area with the operator's palm during operation, thereby facilitating the cutting operation of the saw body 2. According to one embodiment, a friction-enhancing hole 11 is provided on the handle 7, and the friction-enhancing hole 11 is provided through the handle 7. In this way, not only can the friction between the handle 7 and the hand be increased, but also the weight of the handle 7 can be reduced.

[0035] Spinal endoscopy

[0036] The spinal endoscope according to the present invention can be an existing spinal endoscope, a spinal endoscope being developed, or a spinal endoscope invented later. For example, the spinal endoscope according to the present invention can be a JOIMAX spinal endoscope system, a SPINENDOS spinal endoscope system, a STORZ spinal surgery endoscope, or other endoscopes.

[0037] The spinal endoscope reaches the bone surface or the location of the lesion through the channel established by the cavity of the saw body 2. With the light source of the spinal endoscope system providing illumination, the camera and imaging system displays the image of the articular process bone surface area on the monitor, and monitors the doctor's tools and movements entering the patient's body. The doctor can directly perform bone cutting operations under direct vision.

[0038] Bone removal calculation device

[0039] The bone removal ring saw according to the present invention is also provided with a bone removal amount calculation device. Figure 5 and Figure 6 According to the present invention, an annular depth scale 9 and a longitudinal area scale 10 are arranged on the inner side wall of the hollow saw body main part. The annular depth scale 9 and the longitudinal area scale 10 are arranged perpendicularly and staggered to each other. The bone removal volume can be calculated by combining the annular depth scale 9 and the longitudinal area scale 10, thereby providing an accurate bone removal amount.

[0040] Specifically, for example, the scale unit of the annular depth scale 9 can be set to 5 mm, and the angle between adjacent vertical scale lines of the longitudinal area scale 10 in the horizontal direction relative to the axis of the hollow saw body main part can be set to 45°. When measuring human bones, the area of ​​bone removal is calculated based on the size on the annular depth scale 9 and the size of the bone on the longitudinal area scale 10.

[0041] Below, reference Figure 7 Describe the method for calculating bone removal. Figure 7 In the figure, the circle shown is the field of view of the endoscope, and AH is the vertical axis area scale. In this example, the resolution of the vertical axis area scale is set to 45 degrees. Below, some examples of bone resection calculation results are given.

[0042] a. When the bone cutting line is measured as CED, the bone cutting area is:

[0043]

[0044] b. When the bone cutting line is measured as ACEDB, that is, a semicircle, the bone cutting area is:

[0045]

[0046] c. When the bone cutting line is measured as FACEDBH, the cutting area is:

[0047]

[0048] d. When the bone cutting area is measured to be ACEDBHGFA, which is the entire circle:

[0049] Area = πr 2 ;

[0050] In the above formulas of a, b, c and d, r is the radius of the inner diameter of the hollow cylindrical cavity of the saw body 2.

[0051] According to the above-mentioned bone cutting area calculation formula, the area of ​​bone removed can be calculated, which avoids the situation where too little bone is cut to achieve an effective treatment effect, or too much bone is cut to affect the nerves and cause the dorsal saw bone to lose direction.

[0052] The bone resection volume can be obtained by multiplying the calculated bone resection area by the bone resection depth shown on the circular depth scale.

[0053] According to another embodiment, the annular depth scale of the bone cutting amount calculation device can be set on the outer surface of the saw body main part. Since the saw body 2 is set in the cavity of the protective sleeve 1, a part of the scale on the outer surface of the saw body main part is blocked by the protective sleeve 1. In this case, the bone cutting depth can be determined based on the difference between the scale reading at the beginning of the operation and the scale reading at the end of the operation. The longitudinal axis area scale can still be set on the inner surface of the saw body main part.

[0054] According to another embodiment, the saw body 2 can be connected to the protective sleeve 1 by a threaded connection. Since the distance that the saw body 2 advances when the thread rotates one circle is the pitch of the thread, the depth of bone cutting can be determined according to the number of circles of rotation. In addition, the accuracy can be adjusted by the pitch of the thread used. That is, when the pitch of the thread is small, the depth of each feed can be more accurately controlled, thereby more accurately controlling the amount of bone cutting.

[0055] In addition, although in the above embodiment, the resolution of the longitudinal axis area scale is set to 45 degrees, the resolution of the longitudinal axis area scale is not limited thereto, and may be, for example, 30 degrees, 10 degrees, 1 degree, 0.5 degrees or other degrees. It can be understood that when the resolution of the longitudinal axis and the annular depth scale is increased, the control accuracy of the bone removal amount can be improved.

[0056] Although the above method measures or calculates the amount of bone removal by means of physical scales, the amount of bone removal can also be read and calculated electronically. For example, the initial scene can be photographed within the field of view of a spinal endoscope, and the bone cutting area can be automatically calculated by a computing device. In addition, the bone removal amount calculation device also reads and stores the initial value of the annular depth scale, and automatically calculates the bone removal volume according to the change of the annular depth scale as the operation proceeds, and information such as the bone removal area, bone removal depth, and bone removal volume are displayed on the display to assist the doctor's operation.

[0057] Generally speaking, the bone removal area should not be too large. Too large a bone removal area will affect the stability of the spinal structure. In addition, the depth of bone removal should not be too deep (for example, in addition to preoperative imaging measurements, the conventional default posterior lumbar endoscopic surgery, when the depth of laminectomy exceeds 10mm, fluoroscopic positioning should be performed; when the lateral lumbar endoscopic resection of the superior articular process exceeds 15mm, fluoroscopic positioning should be performed). Too deep bone removal can easily damage the dura mater sac, nerves, or cause dorsal saw bone disorientation.

[0058] Therefore, the bone removal trephine or bone removal amount calculation device according to the present invention may also include an alarm device. The alarm device, for example, sounds an alarm when one or more of the bone cutting depth, bone cutting area or bone cutting volume exceeds a threshold value, or directly shuts down the endoscope system, thereby ensuring the safety of the operation.

[0059] For example, different thresholds may be set for the bone cutting depth, the bone cutting area, or the bone cutting volume, for example, a first threshold, a second threshold, and a third threshold.

[0060] In one embodiment, when one of the bone cutting depth, the bone cutting area and the bone cutting volume reaches a threshold value, the system alarms or shuts down the endoscope system. In another embodiment, when one of the bone cutting depth, the bone cutting area and the bone cutting volume reaches a threshold value, an alarm is issued, and when two or more reach the threshold value, the system is directly shut down, by which the doctor's operation threshold can be increased. For example, the bone cutting depth is a more sensitive parameter than the bone cutting area. In this case, when the bone cutting depth reaches the threshold value, the system is directly shut down, and when the bone cutting depth does not reach the threshold value but the bone cutting area reaches the threshold value, an alarm is issued, but the doctor is still allowed to perform further operations.

[0061] That is to say, in the ring saw according to the present invention, priorities or different weights are set for the parameters of bone cutting to give priority to or focus on monitoring the changes of certain parameters. For example, the alarm parameter can be set as the sum of the bone cutting depth, the bone cutting area and the bone cutting volume, and different weights can be set for each parameter, for example, the weight of the bone cutting depth is set to 0.5, the weight of the bone cutting area is set to 0.3, and the weight of the bone cutting volume is set to 0.2. In this way, combined with the visual scale, safety can be further improved.

[0062] In addition, although one or more of the bone cutting depth, the bone cutting area and the bone cutting volume are used as parameters of the alarm, other parameters can also be used for setting the alarm.

[0063] The following describes the situation where the present invention is used in lumbar endoscopy. When performing bone removal, firstly, preoperative preparation is performed, the patient lies on the operating table with hip and knee flexed, and a pillow is placed on the healthy side of the iliac lumbar region to slightly open the intervertebral foramen on the surgical side. Then, the fixation belt should be placed between the surgical side buttocks and the greater trochanter, and a pillow is placed in front of the chest, and pillows are placed on the outside of the healthy side shoulder joint and knee joint to prevent crush injuries. In addition, routine real-time monitoring of vital signs such as blood pressure, heart rate, electrocardiogram, and blood oxygen saturation is performed.

[0064] After the above steps are completed, the needle insertion point is determined. First, the standard lateral position is adjusted under C-arm fluoroscopy: "the bilateral inferior pedicle notches of the upper vertebra, the bilateral superior articular processes of the lower vertebra, and the posterior edge of the lower vertebra should be overlapped into one image respectively." The surgical lumbar segment is positioned through fluoroscopy, and the puncture point and direction are marked.

[0065] Then perform routine disinfection and spread the towel (the disinfection range is 15-20cm away from the incision), and then select 0.7% local anesthetic and 60ml of lidocaine solution for use. The lidocaine solution is made of 20ml of 2% lidocaine and 40ml of normal saline. The specific usage is 5ml subcutaneously, 10ml superficial fascia, 10ml deep fascia, 10ml superior articular process and 10ml intravertebral foramen.

[0066] Then, insert the needle along the set puncture direction until the superior articular process hits the bone and stops. Insert the guide wire and cut the skin 7 mm with a blade. Fix the guide wire with one hand and insert 1-4 level dilation tubes step by step with the other hand (stop after feeling the resistance against the bone). The inclined surface 3 of the protective sleeve 1 is inserted into the above-mentioned dilation tube. The steps of lumbar spinal endoscopic puncture are mature existing technologies and will not be repeated here.

[0067] When bone removal is performed specifically, the handle 4 on the protective sleeve 1 is held, rotated and pushed forcefully until the inclined surface 3 presses against the bone surface of the upper articular process and stops, and the C-arm fluoroscopy is performed in the anteroposterior position; the expansion sleeve is pulled out, and the saw teeth 6 at the bottom end of the saw body 2 are inserted into the hollow tube body in the protective sleeve 1 through the through hole 5 of the handle 4. The spinal endoscope is inserted into the hollow saw body main part of the saw body 2 through the through hole 8 of the handle 7.

[0068] Then connect the spinal endoscopic surgery system, and use the radiofrequency electric knife head to remove the soft tissue of the upper articular process under continuous saline flushing and direct vision of the spinal endoscope to fully expose the bone surface. Hold the spinal endoscope with the left hand and the second handle 7 with the right hand. Under direct vision of the spinal endoscope, place the inclined surface 3 close to the bone surface of the articular process, and calculate the required bone surface area to be removed according to the longitudinal axis area scale on the inner side of the saw body 2 (see Example 2 for details). The right hand continues to apply force downward clockwise, and under the real-time visualization of the spinal endoscope, stop immediately when the bone block is observed to rotate with the saw body 2. Note that the depth displayed on the annular depth scale must not exceed the preoperative measurement range or the conventional default value, otherwise the direction should be readjusted or the position of the saw tooth 2 should be confirmed through perspective to prevent excessive damage to the nerves and disorientation of the dorsal saw bone. The above operation can be repeated again as required by the range of spinal canal decompression.

[0069] Although the present invention is described above by taking spinal endoscopy as an example, it should be understood that the present invention is not limited thereto. For example, the present invention can also be applied to thoracic endoscopic surgery to remove the articular process bone surface (lateral approach), lumbar posterior endoscopic surgery to remove the lamina, thoracic posterior endoscopic surgery to remove the lamina, cervical posterior endoscopic surgery to remove the lamina, and the like.

[0070] While the present invention has been described with reference to exemplary embodiments, it is to be understood that the invention is not limited to the disclosed exemplary embodiments. The scope of the following claims is to be accorded the broadest interpretation so as to encompass all such modifications and equivalent structures and functions.

Claims

1. A real-time bone removal trephine with visual scale in spinal endoscopy, characterized in that: It comprises a protective sleeve (1), a saw body (2), a spinal endoscope and a bone removal amount calculation device; The protective sleeve (1) comprises a hollow tube body, one end of the hollow tube body is arranged in the form of an inclined surface (3), and the other end is provided with a first handle (4), the first handle (4) is provided with a first through hole (5) communicating with the hollow tube body, The saw body (2) comprises a hollow saw body main part, one end of the hollow saw body main part is provided with saw teeth (6) and the other end is provided with a second handle (7), the second handle (7) is provided with a second through hole (8) communicating with the hollow saw body main part, The hollow saw body main part is arranged in the hollow tube body via the first through hole (5), and the spinal endoscope is arranged in the hollow saw body main part via the second through hole (8); and the bone removal amount calculation device calculates one or more of the bone removal area, the bone removal depth and the bone removal volume; The bone removal amount calculation device is configured by an annular depth scale (9) and a longitudinal area scale (10) arranged on the inner side surface of the saw body main body of the saw body (2), and the annular depth scale (9) and the longitudinal area scale (10) are arranged in a mutually perpendicular and staggered manner; or The bone removal amount calculation device is configured by an annular depth scale arranged on the inner side surface of the saw body main body part of the saw body (2) and a longitudinal axis area scale arranged on the outer side surface of the saw body main body part, and the annular depth scale and the longitudinal axis area scale are arranged in a mutually perpendicular and staggered manner; and The real-time bone removal ring saw further comprises an alarm device, which alarms when one or more of the bone removal area, the bone removal depth and the bone removal volume exceeds a corresponding threshold value.

2. The real-time bone removal trephine with endoscopic scale visualization according to claim 1, characterized in that: The protective sleeve (1) and the saw body (2) are connected via a thread, and the longitudinal axis area scale is changed by rotating the saw body (2) relative to the protective sleeve (1).

3. The real-time bone removal trephine with endoscopic scale visualization according to claim 1, characterized in that: The bone removal area, bone removal depth and bone removal volume are set with different priorities, and the alarm device issues alarms of different levels according to the priorities.

4. The real-time bone removal trephine with endoscopic scale visualization according to claim 1, characterized in that: The alarm device issues an alarm using a combination of the bone removal area, bone removal depth and bone removal volume, and the bone removal area, bone removal depth and bone removal volume are assigned different weights.

5. The real-time bone removal trephine with endoscopic scale visualization according to claim 3 or 4, characterized in that: The calculation result of the bone removal amount calculation device and / or the alarm is displayed on a display.

6. The real-time bone removal trephine with endoscopic scale visualization according to claim 1, characterized in that: The first handle (4) is a T-shaped handle, and the second handle (7) is a hemispherical handle.

7. The real-time bone removal trephine with endoscopic scale visualization according to claim 6, characterized in that: The second handle (7) is hemispherical and is provided with a friction-enhancing hole (11).

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