A coaxial type of cranial drainage tube is guided to be placed in a hidden way

Abstract

The application discloses a coaxial craniocerebral drainage tube hidden placement guide device, which comprises a coaxial and curvature-matched outer sleeve and an inner core, the outer sleeve is a hollow tubular structure, the inner core is sleeved in the inner part of the outer sleeve and can slide in the outer sleeve, the front end of the outer sleeve is provided with a notch, the notch can be clamped with the expanded end of the drainage tube and the tail section of the drainage tube, the front end of the inner core is slightly blunt conical, the rear part of the cone is oval, the front end of the slightly blunt cone is formed by the cooperation of the front pushing inner core and the inner cavity of the outer tube, and the front end of the slightly blunt cone is formed by the cooperation of the front pushing inner core and the inner cavity of the outer tube. The coaxial curved tube type structure is used for establishing a hidden tunnel along the sub-scalp puncture, the expanded end of the drainage tube is clamped into the inner clamping cavity of the front end of the outer sleeve by retracting the coaxial inner core, and the drainage tube is pulled out through the hidden tunnel under the fixation of the outer sleeve, so that the hidden placement purpose of the drainage tube under the scalp is realized by one-time pulling.

Description

Technical Field

[0001] This invention relates to the field of medical device technology, specifically to a guiding device for the incision insertion of a coaxial cranial drainage tube. Background Technology

[0002] The information disclosed in this background section is intended only to enhance understanding of the overall background of the invention and is not necessarily to be construed as an admission or in any way implying that such information constitutes prior art known to those skilled in the art.

[0003] Currently, craniotomy with indwelling drainage tube placement is the most widely used and common method for cranial drainage tube placement in the field of neurosurgery both domestically and internationally. It is suitable for conditions such as intracerebral hematoma, acute obstructive hydrocephalus, chronic subdural hematoma, subdural effusion, intracerebral abscess, and certain other intracerebral tension cysts. Whether using Dandy's burr hole or a fine-hole craniotomy method, the drainage tube placement is widely used clinically due to its minimally invasive and convenient advantages; however, inherent defects in the drainage tube placement methods have affected clinical outcomes.

[0004] The most commonly used fine-hole burr method for drainage tube placement involves incising the scalp or vertically piercing the scalp with a cranial drill bit, then drilling through the skull and dura mater sequentially. A guide needle is used to guide the drainage tube vertically through the scalp, skull foramen, and dura mater until it reaches the target area. The guide needle is then withdrawn, leaving the drainage tube in place. The depth is adjusted, the tube is fixed, and bandaged. However, this method results in a drainage tube that only penetrates the scalp vertically, with no subcutaneous undermining distance. If the Dandy's method is used, involving a small scalp incision, skull burr hole, dura mater incision, drainage tube insertion, and scalp suturing, the drainage tube, while having a certain inclination within the scalp, also lacks subcutaneous undermining distance. Due to the lack of sufficient undermining distance, the drainage tube has poor stability and insufficient soft tissue barrier distance, resulting in easy loosening of the drainage tube, perivascular drainage, and retrograde infection, severely impacting treatment outcomes.

[0005] Currently, in order to improve the placement of intracranial drainage tubes and prolong their indwelling time, some scholars have attempted to improve the placement method in response to the above situation: After successful intracranial placement using the direct puncture method or the Dandy's burr hole method, a second skin incision is made at a certain distance from the original skin puncture site / or incision. Through this incision, a subcutaneous tunnel is created to the original puncture site / or incision using a hemostat. The hemostat is then used to poke out from the original puncture site / or incision, clamp the tail end of the drainage tube, and pull it through the subcutaneous tunnel and out through the second incision. In this way, after the drainage tube exits the skull, it travels a certain distance between the original skin puncture site / or incision and the second skin incision, thus improving the indwelling status of the drainage tube.

[0006] However, due to the inherent structure of the hemostat, it inevitably causes local scalp detachment, requiring a larger incision to guide the drainage tube through the subcutaneous tunnel. The further the tunneling distance, the larger the incision becomes. Sometimes, the hemostat needs to be opened multiple times, resulting in significant scalp detachment and traction. This leads to substantial blood loss, large wounds, severe scalp damage, and patients' inability to tolerate surgery under local anesthesia, making the procedure time-consuming and laborious. Chinese invention patent CN111228629B discloses a cranial drainage tube undermining insertion device, which uses a semi-enclosed structure formed by a conical core and an outer conical core. After disassembly, a slot is exposed to accommodate the end of the drainage tube, and the drainage tube is pulled through the undermining core. The tunneling method allows for the submerged insertion of the drainage tube, but this structure has the following problems: 1. Because the core and outer cone are semi-nested, the resulting tunnel does not completely fit the drainage tube; 2. After the core detaches from the outer cone groove, the wing plates and groove walls on the outer cone can easily cause secondary damage to the wound surface of the tunnel; 3. When the outer cone pulls the drainage tube, the drainage fluid inside the tube will flow out, easily contaminating the wound surface; 4. Because the enlarged tail end of the drainage tube is in a semi-exposed state, it is easily blocked by soft tissue and jammed during retraction, making operation inconvenient and with poor operational stability. Summary of the Invention

[0007] To address the problems existing in the prior art, this invention provides a guiding device for the subcutaneous insertion of a coaxial cranial drainage tube. This device solves the problem of creating a subcutaneous tunnel under the scalp to insert the drainage tube. A subcutaneous tunnel is created by puncturing along the scalp using a coaxial curved tube structure. The coaxial inner core is then retracted to secure the enlarged end of the drainage tube into the inner cavity at the front end of the outer sheath. With the outer sheath fixed in place, the drainage tube is pulled out through the subcutaneous tunnel, achieving the purpose of subcutaneous placement of the drainage tube under the scalp in a single pull.

[0008] The technical solution of the present invention is as follows:

[0009] In a first aspect of the invention, a guiding device for the submerged insertion of a coaxial cranial drainage tube is provided, comprising a coaxial outer tube and an inner core with matching curvature. The outer tube is a hollow tubular structure, and the inner core is fitted inside the outer tube and can slide within the outer tube. A notch is provided at the front end of the outer tube, which can engage the enlarged end and tail section of the drainage tube. The front end of the inner core is a slightly blunt cone, and the rear part of the cone is elliptical. Pushing the inner core forward allows it to cooperate with the front cavity of the outer tube to form a slightly blunt cone front end.

[0010] In some embodiments of the present invention, the outer tube and the inner core are in an arc shape adapted to the curvature of the skull.

[0011] In some embodiments of the present invention, the slightly blunt tapered shape at the front end of the inner core can effectively seal the orifice within the enlarged end of the drainage tube.

[0012] In some embodiments of the present invention, the outer tube and the inner core are not perfectly equal in curvature, or the inner diameter of the rear end of the outer tube is smaller than the outer diameter of the front end of the inner core, so that the inner core cannot be completely withdrawn from the outer tube.

[0013] In some embodiments of the present invention, the side wall notch at the front end of the outer sleeve is flask-shaped, adapted to the enlarged end of the drainage tube, and the end of the drainage tube can be inserted through the notch and pulled forward to be fixed.

[0014] In some embodiments of the present invention, the sliding distance of the inner core within the outer sleeve can meet the needs of tunnel construction, including advancement, insertion of the end of the drainage pipe, sealing, and fixing of the drainage pipe.

[0015] In some embodiments of the present invention, the length of the inner core is greater than the length of the outer tube, and when the inner core is fitted inside the outer tube, the slightly blunt conical front end of the inner core can be exposed from the outer tube.

[0016] In some embodiments of the present invention, a first handle is provided at the rear end of the outer tube, and a second handle is provided at the rear end of the inner core.

[0017] In some embodiments of the present invention, a circular hole is provided on the first handle so that the inner core can pass through the first handle and enter the outer tube, and the second handle plays a limiting role in the sliding of the inner core in the outer tube.

[0018] In some embodiments of the present invention, both the first handle and the second handle are arranged horizontally.

[0019] One or more technical solutions of the present invention have the following beneficial effects:

[0020] (1) The guiding device provided by the present invention forms a coaxial curved tube structure through an outer tube and an inner core.

[0021] The device inserts into the scalp and creates a tunnel under the scalp. The tunnel and drainage tube are highly compatible and fit together. The outer surface of the guiding device is a smooth curved surface. When creating the tunnel, it avoids peeling off the adjacent scalp, resulting in minimal trauma. During the traction of the drainage tube, it can effectively reduce traction resistance.

[0022] (2) The guiding device provided by the present invention can lock the enlarged end of the drainage tube into the notch and pull it forward to embed it into the inner cavity of the front end of the outer tube by setting a flask-shaped notch at the front end of the outer tube. Thus, under the action of external force, the end of the drainage tube is pulled through the constructed tunnel and pulled out, thereby completing the underground placement of the drainage tube. The flask-shaped notch will not damage the drainage tube, making it easy for the tail section of the drainage tube to be locked in. After the traction is completed, it is also easy to remove the tail section of the drainage tube from the outer tube.

[0023] (3) The guiding device provided by the present invention sets the front end of the inner core as a slightly blunt cone. The slightly blunt cone can not only play a puncture role, but also pass smoothly through the loose gap under the scalp when separating, but is not easy to cause sharp damage, scratch or cut soft tissue, thus protecting the integrity of the galea aponeurotica layer and adjacent soft tissue, and facilitating the soft tissue of the tunnel wall to retract and wrap the drainage tube; it can also effectively seal the tube hole at the end of the drainage tube when the drainage tube is inserted, preventing the drainage fluid in the cranium from flowing out, avoiding the drainage fluid from flowing out and causing pollution to the wound, and also preventing blood clots, soft tissue and other substances from entering the drainage tube.

[0024] (4) The guiding device provided by this invention has an outer tube and an inner core that are arc-shaped, adapting to the shape of the skull during operation. This facilitates the device's rapid advancement along the scalp and the skull's curvature to establish a subcutaneous tunnel. It also facilitates the withdrawal of the drainage tube along the skull's curvature, minimizing interference with the scalp structure and causing gentle traction and minimal damage to the drainage tube. The adjacent scalp is not pulled or peeled off. The formed tunnel has high conformity to the drainage tube, resulting in less trauma, less bleeding, and minimal damage to the soft tissue of the tunnel wall. Its good retraction properties provide excellent encapsulation of the drainage tube. This type of subcutaneous tunnel has good stability and provides good fixation for the drainage tube. Crucially, it has an excellent barrier effect, which will significantly improve craniocerebral drainage.

[0025] The indwelling status of the tube and the extension of the indwelling time can improve the therapeutic effect of drainage.

[0026] (5) The outer tube and inner core of the guiding device provided by the present invention are non-uniform arc shape or the diameter of the inner hole at the rear end of the outer tube is smaller than the diameter of the front end expansion part of the inner core. The inner core is not easy to completely withdraw from the outer tube, so the whole device is not easy to separate or lose. In addition, the mobility of the inner core in the front end of the outer tube is sufficient to meet the working needs of tunnel construction, such as propulsion, insertion, sealing and fixing of the drainage pipe at the rear end.

[0027] (6) The guiding device provided by the present invention is practical and simple in design concept, simple in structure, sturdy and durable, and easy to operate. The horizontal handle is set to facilitate the smooth control of the puncture direction of the guiding device, and the arc structure makes it convenient for the hand to be close to the head for operation. The outer tube and inner core are both integral structures without other parts, so there will be no loosening or falling off of parts during operation. Attached Figure Description

[0028] Figure 1 This is a top view of the guiding device in Embodiment 1 of the present invention;

[0029] Figure 2 This is a side view of the inner core in Embodiment 1 of the present invention;

[0030] Figure 3 This is a top view of the inner core in Embodiment 1 of the present invention;

[0031] Figure 4This is a side view of the front end of the outer sleeve in Embodiment 1 of the present invention;

[0032] Figure 5 This is a top view of the front end of the outer sleeve in Embodiment 1 of the present invention;

[0033] Figure 6 This is a schematic cross-sectional view of the front end of the inner core along the central longitudinal axis in Embodiment 1 of the present invention;

[0034] Figure 7 This is a cross-sectional view of the bulging portion at the front end of the inner core in Embodiment 1 of the present invention;

[0035] Figure 8 This is a schematic cross-sectional view of the front end along the central longitudinal axis when the outer tube and inner core are fitted together in Embodiment 1 of the present invention;

[0036] Figure 9 This is a top view of the outer tube and inner core mating in Embodiment 1 of the present invention;

[0037] Figure 10 This is a schematic cross-sectional view along the central longitudinal axis of the outer sleeve, the drainage tube, and the inner core when they are fitted together in Embodiment 1 of the present invention;

[0038] Figure 11 is a diagram illustrating the effect of the brain drainage tube placement method in Embodiment 1 of the present invention.

[0039] In the diagram: 1. Outer tube; 2. Inner core; 3. Notch; 4. First handle; 5. Second handle; 6. Slightly blunt conical front end; 7. Rod; 8. Drainage tube; 9. Drainage fluid; 10. Expanded end. Detailed Implementation

[0040] It should be noted that the following detailed description is illustrative and intended to provide further explanation of the invention. Unless otherwise specified, 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 pertains.

[0041] Example 1

[0042] In a typical embodiment of the present invention, a guiding device for the submerged insertion of a coaxial cranial drainage tube is provided, such as... Figure 1As shown, the guiding device includes a coaxial outer tube 1 and an inner core 2 with matching curvature. The inner core 2 is fitted inside the outer tube 1 and can slide inside the outer tube 1. In use, the front end of the inner core 2 is exposed from the front end of the outer tube 1. The inner core 2 and the front inner cavity of the outer tube 1 cooperate to form a slightly blunt conical front end. Under the action of external force, the slightly blunt conical front end enters the subcutaneous tissue through the second scalp incision and advances along the surface of the skull (through the loose gap between the galea aponeurotica and the periosteum) toward the first incision position of the drainage tube entering the skull, thereby establishing a subcutaneous tunnel until the front end of the guiding device pierces out from the incision and the notch on the side wall of the outer tube is exposed.

[0043] like Figure 2 , 3 As shown in Figures 6 and 7, the front end of the inner core 2 is a slightly blunt cone, and the rear end of the cone is elliptical. The rear end of the inner core 2 is provided with a second handle 5. The slightly blunt cone front end 6 and the second handle 5 are connected by a rod 7 to form an integral inner core 2.

[0044] like Figure 4 and Figure 5 As shown, the outer sleeve 1 is a hollow tubular structure. A notch 3 is formed at the front end of the outer sleeve 1. The notch 3 is used to engage the enlarged end and tail end of the drainage tube.

[0045] The notch 3 at the end is flask-shaped, which is adapted to the enlarged end of the drainage tube; a first handle 4 is provided at the rear end of the outer tube 1. A round hole is opened on the first handle 4, which allows the inner core 2 to pass through the first handle 4 and enter the outer tube 1. The inner diameter of the first handle is smaller than the enlargement of the front end of the inner core, thus restricting its complete withdrawal. The second handle plays a limiting role in the forward sliding of the inner core in the outer tube.

[0046] In this embodiment, both the first handle 4 and the second handle 5 are arranged horizontally. This structure improves the grip and control feel when holding with one hand, which is conducive to one-handed operation. The entire operation can be completed by one person.

[0047] In this embodiment, the outer tube 1 and the inner core 2 are arc-shaped to conform to the curvature of the skull. During operation, the guiding device can adapt to the shape of the skull, which is conducive to the device advancing along the scalp along the curvature of the skull to quickly establish a subscalp tunnel. It is also conducive to pulling the drainage tube out along the curvature of the skull.

[0048] Furthermore, the outer sleeve 1 and the inner core 2 are non-uniform arc shapes, and / or the inner diameter of the first handle is smaller than the expansion at the front end of the inner core, making it difficult for the inner core 2 to completely exit from the outer sleeve. This makes the entire guiding device less prone to separation or loss. At the same time, the mobility of the inner core within the front section of the outer sleeve is sufficient to meet the operational needs of tunnel construction, such as advancement, insertion, sealing, and fixing of the drainage pipe at the rear end.

[0049] As shown in Figures 8 and 9, the length of the inner core 2 is greater than the length of the outer tube 1. The inner core 2 is fitted inside the outer tube 1. When the first handle 4 and the second handle 5 are in contact, the slightly blunt conical front end 6 of the inner core 1 can be exposed from the outer tube. The front end face of the outer tube 1 is rounded. The slightly blunt conical front end 6 of the inner core 1 and the front end of the outer tube are smoothly transitioned and fit together, which can avoid local subscalp soft tissue embedding and reduce the resistance when the device is pushed along the subscalp.

[0050] In operation, as shown in Figure 10, the guiding device provided in this embodiment involves pushing the inner core 1 forward to align the first handle 4 and the second handle 5. The slightly blunt conical front end of the inner core 1, together with the front inner cavity of the outer sleeve 1, forms a slightly blunt conical front end. During use, the rear horizontal handle of the guiding device is held, and under pushing force, the front end is inserted under the scalp through the second scalp incision and advanced along the skull surface, towards the first incision for the drainage tube to enter the skull (the length of the first incision needs to be close to 1 cm to avoid difficulty in the front end of the guiding device being too small to pass through). This establishes a subcutaneous tunnel. The front end of the guiding device is then pushed out through this incision until the notch on the side wall of the outer sleeve is exposed. The inner core 1 is then withdrawn, and the drainage tube is straightened. In a twist-free state, the enlarged end 10 of the drainage tube is inserted through the notch 3 on the side wall of the outer sleeve 1. Moderate traction is used to embed the enlarged end of the drainage tube into the notch cavity at the front end of the outer sleeve and fix it in place. The inner core 2 is pushed forward slightly and tension is maintained to seal the drainage tube opening and prevent intracranial drainage fluid from flowing out. Hold the handle at the back of the guide device and pull the drainage tube through the subcutaneous tunnel and out of the body through the second incision. Check that the drainage tube is free of kinks and unfolded. Suture the incision, fix the drainage tube, bandage and connect the drainage device. The final effect of the drainage tube infiltration is shown in Figure 11.

[0051] The coaxial cranial drainage tube insertion guide device provided in this embodiment establishes a tunnel under the scalp through a coaxial curved tube structure. The coaxial inner core is then withdrawn to lock the enlarged end of the drainage tube into the inner cavity at the front end of the outer sleeve for fixation. Under the fixation of the outer sleeve, the drainage tube is pulled out through the tunnel, achieving the purpose of subcutaneous placement of the drainage tube in one pull.

[0052] The embodiments described above provide a detailed explanation of the technical solution of the present invention. It should be understood that the above descriptions are merely specific embodiments of the present invention and are not intended to limit the present invention. Any modifications, additions, or similar substitutions made within the scope of the principles of the present invention should be included within the protection scope of the present invention.

Claims

1. A guiding device for the submerged insertion of a coaxial cranial drainage tube, characterized in that, The device includes a coaxial outer tube and an inner core with matching curvature. The outer tube is a hollow tubular structure, and the inner core is fitted inside the outer tube and can slide within it. The front end of the outer tube has a notch that engages with the enlarged end and tail section of the drainage tube. The front end of the inner core is a slightly blunt cone, with an elliptical rear portion. A first handle is located at the rear end of the outer tube, and a second handle is located at the rear end of the inner core. The length of the inner core is greater than the length of the outer tube. When the inner core is pushed forward, the slightly blunt cone-shaped front end of the inner core protrudes from the outer tube when the first and second handles are engaged. The front end of the outer tube has a rounded chamfer, and the slightly blunt cone-shaped front end smoothly transitions to the front end of the outer tube, fitting together perfectly. The slightly blunt cone-shaped front end effectively seals the orifice within the enlarged end of the drainage tube.

2. The guiding device for the submerged insertion of the coaxial cranial drainage tube as described in claim 1, characterized in that, The outer tube and inner core are arc-shaped to conform to the curvature of the skull.

3. The guiding device for the submerged insertion of the coaxial cranial drainage tube as described in claim 1, characterized in that, The outer tube and the inner core are non-uniform arc shapes, making it difficult for the inner core to completely exit from the outer tube.

4. The guiding device for the submerged insertion of the coaxial cranial drainage tube as described in claim 1, characterized in that, The side wall notch at the front end of the outer sleeve is flask-shaped, which is adapted to the enlarged end of the drainage tube.

5. The guiding device for the in-situ insertion of the coaxial cranial drainage tube as described in claim 1, characterized in that, The sliding distance of the inner core within the outer tube is sufficient to meet the needs of tunnel construction, including advancement, insertion, sealing, and fixing of the drainage pipe end.

6. The guiding device for the in-situ insertion of the coaxial cranial drainage tube as described in claim 1, characterized in that, The first handle has a round hole, which allows the inner core to pass through the first handle and enter the outer tube. The second handle limits the sliding of the inner core within the outer tube.

7. The guiding device for the submerged insertion of the coaxial cranial drainage tube as described in claim 1, characterized in that, Both the first handle and the second handle are positioned horizontally.

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