A double-channel endoscopic nerve retractor

Abstract

The present invention provides a double-channel borescope nerve retractor, comprising: a first blade, a second blade and an expansion drive mechanism, an annular plate is arranged at one end of the first blade, the expansion drive mechanism is connected to the annular plate, the connection between the expansion drive mechanism and the annular plate is connected to the second blade, the expansion drive structure is used to drive the second blade to move away from the first blade; the length of the first blade is less than the length of the second blade. The present invention adopts a double-blade expansion structure, which effectively solves the problem that the direction of force is difficult to grasp during expansion. At the same time, the working channel formed by the annular plate and the two blades has good stability, which can effectively retract the nerve root without affecting the operation of the surgeon's instrument.

Description

Technical Field

[0001] The invention belongs to the technical field of medical equipment, and in particular relates to a nerve retractor used under a double-channel borescope. Background Art

[0002] The double-channel borescope is a new type of minimally invasive spinal surgery technology. It makes two small incisions at the back of the spine, expands the muscles and fascia to form an operation channel and an observation channel, reaches the surgical site, and inserts a spinal endoscope from the observation channel. The radiofrequency blade, grinding drill, gun-shaped bone forceps, nucleus pulposus forceps and other tools are inserted into the operation channel to remove the vertebral plate, ligaments, loosen the nerve roots, remove the nucleus pulposus and perform intervertebral disc related operations, including radiofrequency ablation, intervertebral disc fiber ring suture or implantation of intervertebral fusion device to complete the surgical operation. When performing intervertebral disc related operations, the nerve roots need to be retracted and protected to achieve the purpose of exposing the surgical site and preventing nerve damage. Nerve damage may cause incomplete paralysis of the patient's lower limbs or urinary and bowel dysfunction. The present invention manufactures an automatic nerve retractor that can retract and protect the nerve roots more stably, the retraction force is adjustable, and the operation is convenient. The channel formed by the retractor is stable, which is convenient for the surgeon to operate.

[0003] Currently, during surgery, the assistant mainly holds a nerve retractor to protect and retract the nerve root. The assistant is located on the opposite side of the surgeon, holding an L-shaped nerve retractor and entering through the operation hole, placing it on the outside of the nerve root, and then retracting the nerve root inward to expose the protruding nucleus pulposus and the rupture of the annulus fibrosus. After protection, the surgeon also enters through the operation channel, avoids the nerve retractor, and inserts the radiofrequency blade, nucleus pulposus forceps, annulus fibrosus suture device or intervertebral fusion device to complete the operation.

[0004] Because the operation channel of minimally invasive surgery is small and deep, the assistant's field of vision is limited when holding, and it is difficult to control the strength and direction of retraction. Excessive retraction or incorrect retraction may cause nerve root retraction injury. If the retraction is too light, the nerve root enters the surgical operation area, hindering the surgeon's operation or causing nerve root damage. The nerve retractor and the surgeon's operating instruments are located in the same channel and interfere with each other, which may affect the surgeon's operation, resulting in prolonged surgery time or surgical errors. Summary of the invention

[0005] In response to the above technical problems, the present invention provides a dual-channel endoscopic nerve retractor, which adopts a double-blade expansion structure to effectively solve the problem that the direction of force is difficult to control during expansion. At the same time, the working channel formed by the annular plate and the two blades has good stability and can effectively retract the nerve roots without affecting the surgeon's instrument operation.

[0006] To achieve the above object, the technical solution of the present invention is: A double-channel borescope nerve retractor comprises: a first blade, a second blade and an expansion drive mechanism, wherein an annular plate is arranged at the proximal end of the first blade, the expansion drive mechanism is connected to the annular plate, and the connection between the expansion drive mechanism and the annular plate is connected to the second blade, and the expansion drive structure is used to drive the second blade to move in a direction away from the first blade; The length of the first blade is smaller than the length of the second blade.

[0007] In a preferred embodiment, the expansion drive mechanism includes a first handle and a second handle; The first handle is fixedly connected to the annular plate, the second blade is rotatably connected to the second handle, and the rotation connection point is on the annular plate; When the second handle approaches the first handle, the second blade moves away from the first blade. A locking mechanism is provided between the first handle and the second handle, and the locking mechanism is used to lock the position of the second handle and the first handle.

[0008] In a preferred embodiment, the locking mechanism is an elastic retaining spring sheet, which is provided with a plurality of protrusions, and the first handle is provided with a through hole, one end of the elastic retaining spring sheet is fixedly connected to the second handle, and the other end of the elastic retaining spring sheet passes through the first handle, and the protrusion is engaged in the through hole.

[0009] In a preferred embodiment, the locking mechanism is a locking plate, one end of which is hinged to the second handle, a plurality of protrusions are provided on the locking plate, a slot is provided on the first handle, and the protrusion is snapped into the slot to lock the positions of the first handle and the second handle.

[0010] In a preferred embodiment, the distal end of the second blade has a hook.

[0011] In a preferred embodiment, the width of the first blade is greater than the width of the second blade.

[0012] In a preferred embodiment, the width of the first blade is 1-1.2 cm.

[0013] In a preferred embodiment, the width of the second blade gradually decreases from the proximal end to the distal end.

[0014] In a preferred embodiment, the width of the portion of the second blade close to the annular plate is 0.8-1 cm.

[0015] In a preferred embodiment, the proximal end portions of the first blade and the second blade have a curvature in the width direction.

[0016] Due to the adoption of the above technical solution, the present invention has the following advantages and positive effects compared with the prior art: The present invention includes a first blade, a second blade and an expansion drive mechanism for driving the first blade and the second blade to spread apart, and an annular plate is provided at one end of the first blade, the second blade is connected to the expansion drive mechanism on the annular plate, and the expansion drive mechanism drives the second blade to rotate in a direction away from the first blade, thereby expanding the angle between the second blade and the first blade.

[0017] During the operation, after the doctor forms the operation channel, the first blade and the second blade extend into the operation channel, and the second blade is used to retract the nerve root. Since the second blade is longer than the first blade, the first blade is supported on the soft tissue, and the first blade can also block the soft tissue, muscle, fat, etc. from blocking the operation channel. The expansion drive mechanism drives the second blade to move away from the first blade, retract the nerve root, and reveal the surgical operation field of view, so that the first blade, the second blade and the through hole of the annular plate form a stable working channel, and the operating doctor can extend the operating instrument (such as nucleus pulposus forceps, radiofrequency ablation blade, fiber ring suture device, intervertebral fusion device, etc.) through the through hole of the annular plate for operation. The channel formed by blade A and blade B is stable and will not hinder the operation of the instrument. After the operation is completed, the second blade moves closer to the first blade to relax the retracted nerve root, and the first blade and the second blade that are close together are taken out of the operation channel. Therefore, the present invention adopts a double-blade expansion structure, which can effectively solve the problem that the direction of force is not easy to grasp during expansion, and the working channel formed by the through hole of the annular plate and the two blades has good stability, which can effectively retract the nerve root without affecting the operation of the surgeon's instrument. BRIEF DESCRIPTION OF THE DRAWINGS

[0018] Figure 1 The structure of the double-channel borescope nerve retractor according to the embodiment of the present invention is shown in FIG. Figure 1 ; Figure 2 The structure of the double-channel borescope nerve retractor according to the embodiment of the present invention is shown in FIG. Figure 2 ; Figure 3 It is a schematic diagram of a double-channel borescope in an embodiment of the present invention when the nerve retractor is in a stretched state.

[0019] Explanation of the reference numerals: 1 - first blade; 2 - second blade; 3 - hook; 4 - annular plate; 5 - first handle; 6 - second handle; 7 - elastic spring; 8 - protrusion; 9 - arc; 10 - through hole. DETAILED DESCRIPTION

[0020] The following is a further detailed description of a dual-channel borescope nerve retractor proposed by the present invention in conjunction with the accompanying drawings and specific embodiments. The advantages and features of the present invention will become more apparent from the following description.

[0021] See also Figure 1-3 A double-channel borescope nerve retractor comprises: a first blade 1, a second blade 2 and an expansion drive mechanism, a proximal end of the first blade 1 is provided with an annular plate 4, the expansion drive mechanism is connected to the annular plate 4, and the connection between the expansion drive mechanism and the annular plate 4 is connected to the second blade 2, and the expansion drive mechanism is used to drive the second blade 2 to move in a direction away from the first blade 1; The length of the first blade 1 is smaller than the length of the second blade 2 .

[0022] In this embodiment, since the second blade 2 is connected to the expansion drive mechanism on the annular plate 4, and the first blade 1 is fixedly connected to the annular plate 4, the expansion drive mechanism can drive the second blade 2 to move in a direction away from the first blade 1, thereby increasing the angle formed by the second blade 2 and the first blade 1. Therefore, the second blade 2 can be used to retract the nerve root, and the first blade 1 is shorter in length, forming a support point at the soft tissue to prevent soft tissues such as muscle and fat from blocking the operation channel. The distal end of the first blade 1 is preferably designed to be an arc 9, that is, a rounded corner is set to prevent further cutting of the soft tissue. Therefore, the first blade 1, the second blade 2 and the through hole 10 of the annular plate 4 form a stable channel, and the doctor's operating instrument can be inserted into the through hole 10 of the annular plate 4 for operation. The channel formed by the first blade 1 and the second blade 2 is stable and will not hinder the operation of the instrument.

[0023] In this embodiment, the expansion drive mechanism includes a first handle 5 and a second handle 6. Both the first handle 5 and the second handle 6 are provided with handle covers to increase comfort.

[0024] The first handle 5 is fixedly connected to the annular plate 4, and the second blade 2 is rotatably connected to the second handle 6, and the rotation connection point is on the annular plate 4; when an external force acts on the second handle 6 and the second handle 6 moves toward the first handle 5, the second blade 2 can be driven to move away from the first blade 1, thereby increasing the angle between the second blade 2 and the first blade 1, that is, the second blade 2 and the first blade 1 are spread apart; after the force of the second handle 6 disappears, the second blade 2 returns to its original position, that is, the second blade 2 is retracted.

[0025] In order to maintain the folded position of the second blade 2 and the channel formed by the second blade 2 and the first blade 1 during the operation, a locking mechanism is provided between the first handle 5 and the second handle 6, and the locking mechanism is used to lock the position of the second handle 6 and the first handle 5, that is, after the force on the second handle 6 disappears, due to the action of the locking mechanism, the position of the second handle 6 and the first handle 5 remains unchanged, and the opening angle of the second blade 2 is maintained.

[0026] In a preferred embodiment, the locking mechanism is an elastic retaining spring 7, which is provided with a plurality of protrusions 8. A through hole is provided on the first handle 5, and a slot for engaging the protrusion 8 is provided in the through hole. One end of the elastic retaining spring 7 is fixedly connected to the second handle 6, and the other end of the elastic retaining spring 7 passes through the first handle 5, and the protrusion 8 is engaged in the slot of the through hole.

[0027] When the second handle 6 moves toward the first handle 5, the elastic spring 7 pops up, and the toothed protrusion 8 on the elastic spring 7 is engaged in the slot of the through hole of the first handle 5, so that the force and range of the expansion can be controlled step by step. At the same time, the engagement of the protrusion 8 with the slot can prevent the second handle 6 and the first handle 5 from returning to their original positions, thereby preventing the second blade 2 from failing to expand and damaging the nerve root. After the operation is completed, the elastic spring 7 is pressed downward to separate the second handle 6 and the first handle 5 step by step, and the second blade 2 and the first blade 1 are brought closer to each other to relax the retracted nerve root.

[0028] The protrusion 8 may be a tooth-shaped protrusion 8 , and a tooth-shaped groove meshing with the tooth-shaped protrusion 8 is provided in the through hole.

[0029] In another embodiment, the locking mechanism is a locking plate, one end of which is hinged to the second handle 6, and a plurality of protrusions 8 are provided on the locking plate. A slot is provided on the first handle 5, and the protrusion 8 is snapped into the slot to lock the position of the first handle 5 and the second handle 6.

[0030] When the second handle 6 moves to a certain position toward the first handle 5, the second blade 2 is opened, and the second blade 2 retracts the nerve root to expose the surgical position. At this time, the protrusion 8 on the locking plate can be snapped into the slot on the first handle 5 to fix the position of the second handle 6. Since there are multiple protrusions 8 on the locking plate, the force and range of the opening can be controlled step by step. At the same time, the engagement of the protrusion 8 with the slot can prevent the second handle 6 and the first handle 5 from returning to their original positions, thereby preventing the second blade 2 from failing to open and damaging the nerve root. After the surgical operation is completed, the protrusion 8 is separated from the slot, and the second handle 6 and the first handle 5 can be separated, and the second blade 2 and the first blade 1 are brought closer to each other to relax the retracted nerve root.

[0031] Since the second blade 2 is located outside the nerve root, a hook 3 is provided at the distal end of the second blade 2 . The hook 3 is placed on the ventral side of the nerve root to prevent the nerve root from slipping out of the distal end of the second blade 2 .

[0032] Since the function of the first blade 1 is to block the muscles to form a soft tissue operating channel, the width of the first blade 1 is preferably greater than the width of the second blade 2, which can achieve a better blocking effect. Preferably, the width of the first blade 1 is 1-1.2 cm, which is more suitable for the operating channel formed during minimally invasive spinal surgery.

[0033] Since the first blade and the second blade form a channel, the first blade blocks soft tissues such as muscles, and the proximal end of the second blade can also block the soft tissues such as muscles, so the width of the second blade 2 gradually decreases from the proximal end to the distal end. The second blade 2 mainly acts to retract the nerve roots, but the proximal part contacts the soft tissue and has a certain width and can also block muscles, etc. The distal end retracts the nerve roots and has a narrower width. Preferably, the width of the proximal part of the second blade 2 is 0.8-1cm. Furthermore, the first blade 1 has a certain curvature in the width direction, the proximal part of the second blade 2 has a certain curvature in the width direction, and the curvatures of the first blade 1 and the second blade 2 are relatively set. In the operating channel, the first blade 1 and the second blade 2 are more likely to form a tubular channel, and the channel formed by the first blade 1 and the second blade 2 is more stable, and the effect of blocking soft tissue is better, thereby making the surgical operation space larger.

[0034] Taking the elastic spring 7 as an example, the working principle of the nerve retractor of the present application is explained: During the operation, the doctor makes two small incisions at the back of the spine, expands the muscles and fascia to form an operation channel and an observation channel, inserts the spinal endoscope from the observation channel, and the first blade 1 and the second blade 2 are inserted into the operation channel. The second blade 2 is located outside the nerve root, and the hook 3 is placed on the ventral side of the nerve root to prevent the nerve root from slipping out of the distal end of the second blade 2. The first blade 1 is supported at the operation channel formed by the muscle, and the handle is clamped. When the second handle 6 moves toward the first handle 5, the second blade 2 moves away from the first blade 1. While the second blade 2 moves, the nerve root is pulled away, revealing the surgical operation field. When the second blade 2 moves away from the first blade 1, the elastic spring sheet 7 pops up, and the toothed protrusion 8 on the elastic spring sheet 7 is clamped in the through hole of the first handle 5, so that the force and range of the expansion can be controlled step by step. At the same time, the protrusion 8 is clamped with the through hole to prevent the second handle 6 and the first handle 5 from returning to their original positions, thereby preventing the second blade 2 from failing to expand and damaging the nerve root. The second blade 2 and the first blade 1 are located in the muscle channel, which can prevent them from sliding or rotating toward the distal or proximal ends, causing the nerve root to be retracted in the wrong position and damage the nerve root. The surgeon can insert the operating instruments (such as nucleus pulposus forceps, radiofrequency ablation blade, fiber ring suture device, intervertebral fusion device, etc.) through the through hole 10 of the annular plate 4 for operation. The channel formed by the first blade 1 and the second blade 2 is stable and will not hinder the operation of the instruments.

[0035] After the surgical operation is completed, the elastic spring sheet 7 is pressed downward, and the protrusion 8 is disengaged from the slot in the through hole, so that the second handle 6 and the first handle 5 can be separated step by step, and the second blade 2 and the first blade 1 are brought closer to each other, the retracted nerve root is relaxed, and the first blade 1 and the second blade 2 that are brought together can be taken out of the operation channel.

[0036] The distance between the first blade and the second blade in the folded state can be set arbitrarily according to actual needs, and the drawings in this application are only for illustration.

[0037] The present invention adopts a double-leaf expansion structure, which effectively solves the problem that the direction of force is difficult to control during expansion. The elastic spring plate or locking plate is used, which can be expanded step by step and adjusted, making it easy to control the force and range of expansion, and at the same time preventing the expanded leaves from causing expansion failure. The working channel formed by the through hole of the annular plate and the two leaves has good stability, which can effectively retract the nerve root without affecting the operation of the surgeon's instruments.

[0038] The embodiments of the present invention are described in detail above in conjunction with the accompanying drawings, but the present invention is not limited to the above embodiments. Even if various changes are made to the present invention, if these changes fall within the scope of the claims of the present invention and their equivalents, they still fall within the protection scope of the present invention.

Claims

1. A double-channel borescope nerve retractor, characterized in that: include: A first blade, a second blade and an expansion drive mechanism, wherein an annular plate is arranged at the proximal end of the first blade, the expansion drive mechanism is connected to the annular plate, and the connection between the expansion drive mechanism and the annular plate is connected to the second blade, the expansion drive mechanism is used to drive the second blade to move in a direction away from the first blade, and the through hole of the annular plate forms a channel with the second blade and the first blade; The length of the first blade is smaller than the length of the second blade.

2. The double-channel endoscopic nerve retractor according to claim 1, characterized in that: The expansion drive mechanism includes a first handle and a second handle; The first handle is fixedly connected to the annular plate, the second blade is rotatably connected to the second handle, and the rotation connection point is on the annular plate; when the second handle approaches the first handle, the second blade moves in a direction away from the first blade; A locking mechanism is provided between the first handle and the second handle, and the locking mechanism is used to lock the position of the second handle and the first handle.

3. The double-channel endoscopic nerve retractor according to claim 2, characterized in that: The locking mechanism is an elastic spring sheet, which is provided with multiple protrusions. The first handle is provided with a through hole. One end of the elastic spring sheet is fixedly connected to the second handle, and the other end of the elastic spring sheet passes through the first handle, and the protrusion is clamped in the through hole.

4. The double-channel endoscopic nerve retractor according to claim 2, characterized in that: The locking mechanism is a locking plate, one end of which is hinged to the second handle, a plurality of protrusions are provided on the locking plate, a slot is provided on the first handle, and the protrusion is engaged in the slot to lock the positions of the first handle and the second handle.

5. The double-channel endoscopic nerve retractor according to claim 1, characterized in that: The distal end of the second blade has a hook.

6. The double-channel endoscopic nerve retractor according to claim 1, characterized in that: The width of the first blade is greater than the width of the second blade.

7. The double-channel endoscopic nerve retractor according to claim 1, characterized in that: Proximal end portions of the first blade and the second blade have a curvature in a width direction.

8. The double-channel endoscopic nerve retractor according to claim 1 or 6, characterized in that: The width of the first blade is 1-1.2 cm.

9. The double-channel endoscopic nerve retractor according to claim 1, characterized in that: The width of the second blade gradually decreases from the proximal end to the distal end.

10. The double-channel endoscopic nerve retractor according to claim 8, characterized in that: The width of the portion of the second blade close to the annular plate is 0.8-1 cm.

Images