Bypass pipeline for intracranial ventricular temporal angle-frontal angle bypass surgery

Abstract

The intracranial ventricular temporal angle-frontal angle bypass pipeline comprises a three-way flow guide pipe, a frontal angle hydrotubation pipe and a connector, the first end of the three-way flow guide pipe is arranged in a ventricular temporal angle, and the second end of the three-way flow guide pipe is detachably connected with one end of the frontal angle hydrotubation pipe through the connector; the connecting joint is used for blocking / communicating the second end part of the three-way flow guide tube and the frontal angle hydrotubation tube, the other end of the frontal angle hydrotubation tube is arranged in the frontal angle of the ventricle, and the third end of the three-way flow guide tube is used for being connected with a liquid storage bag below the scalp or being led out of the scalp. According to the bypass pipeline for the bypass surgery, the three-way flow guide pipe is adopted, the third end of the three-way flow guide pipe is used for being connected with the liquid storage bag or leading out the scalp, and a cerebrospinal fluid sample can be reserved for testing by means of the third end of the three-way flow guide pipe, so that clinical diagnosis is assisted; meanwhile, the end can be used for implementing liquid pumping and pressure reducing operation so as to reduce intracranial pressure.

Description

Technical Field

[0001] The invention relates to the technical field of ventricular bypass surgery, and in particular to a bypass conduit for intracranial ventricular temporal horn-frontal horn bypass surgery. Background Art

[0002] Isolated temporal horn syndrome is a common complication after neurosurgery for intraventricular tumors. Water accumulation leads to isolated expansion of the temporal horn, causing disability or even death in patients, and is very difficult to treat. The principle of the current treatment method is to drain the water accumulation in the temporal horn to an absorbable area (such as the abdominal cavity, the prepontine cistern, and the lateral ventricle), including ventriculoperitoneal shunt, endoscopic choroidal fissure ostomy, and diversion. Among them, ventriculoperitoneal shunt drains the cerebrospinal fluid in the temporal horn to the peritoneal cavity for absorption. Its disadvantage is that the pipeline path is long, which breaks the physiological circulation of cerebrospinal fluid. Shunt blockage and infection often occur. Shunt-dependent headache and abdominal complications occur in the long term. Reoperation is required to adjust the shunt, which is expensive and increases the pain of patients. Endoscopic choroidal fissure ostomy drains the cerebrospinal fluid in the temporal horn to the prepontine cistern through the medial choroidal fissure of the temporal horn. It has high technical requirements for the operator, complex anatomical structure, and is prone to complications such as brainstem and vascular damage. There is a certain failure rate and reoperation is required, which is difficult to promote. The bypass procedure is to drain the cerebrospinal fluid in the temporal horn to the frontal horn where the cerebrospinal fluid circulates normally through a connecting tube bypass. Compared with the ventriculoperitoneal shunt, the tube path is short, not easy to be blocked and infected, there are no abdominal complications, the operation time is short, and the cost is low. Compared with endoscopic choroidal fissure fistula, the technology is simple and easy to promote.

[0003] However, in clinical practice, the existing single-chamber ventricular end used for bypass surgery has exposed obvious shortcomings and cannot effectively meet the complex and changing clinical needs. Specifically, after the cerebrospinal fluid bypass is completed, if the doctor needs to extract the fluid in the enlarged temporal horn for testing to further clarify the condition, or to perform decompression operations on the patient, the existing single-chamber ventricular end cannot achieve this function; second, for isolated temporal horns that have been infected, the existing single-chamber ventricle cannot effectively establish an external drainage channel to the outside of the skull, and it is even more impossible to conveniently inject drugs into the temporal horn, making it difficult for doctors to carry out targeted treatment and delaying the condition. Summary of the invention

[0004] In view of this, the present invention proposes an intracranial ventricular temporal horn-frontal horn bypass conduit to improve the functionality of the bypass conduit.

[0005] To achieve the above object, the present invention adopts the following technical solution:

[0006] A bypass conduit for intracranial ventricle temporal horn-frontal horn shunt surgery comprises a three-way drainage tube, a frontal horn liquid passage tube and a connecting joint, wherein the first end of the three-way drainage tube is placed in the temporal horn of the ventricle, the second end of the three-way drainage tube is detachably connected to one end of the frontal horn liquid passage tube via the connecting joint, the connecting joint is used to block / connect the second end of the three-way drainage tube with the frontal horn liquid passage tube, the other end of the frontal horn liquid passage tube is placed in the frontal horn of the ventricle, and the third end of the three-way drainage tube is used to connect to a fluid storage bag under the scalp or to lead out of the scalp.

[0007] To better implement the above technical solution, optionally, a plurality of side outlet holes are evenly distributed on the side wall of one end of the frontal angle liquid passage tube located in the frontal angle of the ventricle.

[0008] Optionally, the end of the frontal angle fluid passage tube located in the frontal angle of the ventricle is in the shape of a round cone.

[0009] Optionally, a plurality of liquid inlet side holes are evenly distributed on the side wall of the first end of the three-way flow guiding tube.

[0010] Optionally, the first end of the three-way flow guide tube is a round-head cone.

[0011] Optionally, the connecting joint includes a connecting joint and a blocker which are independently arranged from each other.

[0012] Optionally, the blocker includes a blocker body with a cylindrical structure, a first joint is coaxially fixed to one end of the blocker body, and a second joint is coaxially fixed to the other end of the blocker body, the first joint is detachably connected to the end of the frontal angle liquid passage tube away from the frontal angle, and the second joint is detachably connected to the second end of the three-way diversion tube.

[0013] Optionally, the first connector and the second connector both include a binding section and a plug section, the two ends of the binding section are respectively connected to one end of the plug section and one end of the blocker body, the plug section is a round-headed cone structure, the large-diameter end of the plug section is interference fit with the inner wall of the end of the frontal angle liquid passage tube away from the frontal angle area / the inner wall of the second end of the three-way diversion tube, the binding section is a cylindrical structure, and the diameter of the binding section is smaller than the inner diameter of the second end of the frontal angle liquid passage tube and the three-way diversion tube.

[0014] Beneficial effects of the present invention:

[0015] The present invention discloses a bypass conduit for intracranial ventricular temporal horn-frontal horn shunt surgery, which adopts a three-way drainage tube, and the third end of the three-way drainage tube is used to connect to a fluid storage bag under the scalp or lead out of the scalp. The third end of the three-way drainage tube can be used to retain cerebrospinal fluid samples for testing, thereby assisting clinical diagnosis; at the same time, the end can be used to implement a fluid extraction and decompression operation to reduce intracranial pressure. For isolated temporal horns with high protein or infection, the third end of the three-way drainage tube can pass through the scalp as an external drainage tube, and the abnormal cerebrospinal fluid is drained through the external drainage tube until the test results of various indicators are normal. In addition, the third end of the three-way drainage tube can also be used as a channel for antibiotic flushing to introduce antibiotics into the ventricular system to achieve the treatment of intracranial infection and improve the patient's clinical symptoms.

[0016] The bypass conduit for intracranial ventricular temporal angle-frontal angle shunt surgery of the present invention changes the traditional silk thread external tube ligation method to a method of internal tube blocking combined with external tube fixation, which improves the accuracy and stability of the blockage, effectively prevents cerebrospinal fluid leakage, and provides a solid guarantee for the prognosis of the operation. Moreover, during the whole operation, the tube wall of the double-cavity ventricular tube will not be damaged, and the original structural integrity of the ventricular tube is maintained to the greatest extent. In addition, its operation process is greatly simplified, and medical staff can quickly complete the blocking operation with only a few simple steps, which greatly shortens the operation time and reduces the intraoperative risk of patients. BRIEF DESCRIPTION OF THE DRAWINGS

[0017] Figure 1 It is a three-dimensional schematic diagram of a bypass pipeline for intracranial ventricular temporal horn-frontal horn shunt surgery according to an embodiment of the present invention;

[0018] Figure 2 yes Figure 1 Schematic diagram of the application of bypass tube in intracranial ventriculotemporal-frontal horn shunt surgery;

[0019] Figure 3 yes Figure 1 A three-dimensional schematic diagram of the end of the midfrontal angle liquid passage tube placed in the frontal angle;

[0020] Figure 4 yes Figure 2 A three-dimensional schematic diagram of the first end of the middle three-way flow guide pipe;

[0021] Figure 5 yes Figure 1 A three-dimensional schematic diagram of a connecting joint;

[0022] Figure 6 yes Figure 1 A three-dimensional schematic diagram of the middle blocker;

[0023] Figure 7 yes Figure 2 Auxiliary schematic diagram of surgical plan;

[0024] Reference numerals:

[0025] A three-way drainage tube 100, a first end 110, a liquid inlet side hole 111, a second end 120, a third end 130, a frontal angle liquid passage 200, a liquid outlet side hole 201, a connecting joint 300, a blocker 400, a blocker body 410, a first joint 420, a binding section 421, a plug section 422, a second joint 430, a liquid reservoir 500, a Kocher point 601, a Frazier point 602, a blockage point 603 in a common surgical area, a temporal angle of the ventricle 604, a frontal angle 605, bilateral internal auditory canals 701, a zygomatic process 702, a midpoint of the eyebrow arch 703, a first arrow 704, a second arrow 705, a third arrow 706, and a fourth arrow 707. DETAILED DESCRIPTION

[0026] The technical solution of the present invention is described in detail below in conjunction with the accompanying drawings and specific embodiments, wherein the same components are represented by the same reference numerals.

[0027] See also Figures 1 to 7 The embodiment of the present invention discloses a bypass conduit for intracranial ventricle temporal horn-frontal horn shunt surgery, comprising a three-way drainage tube 100, a frontal horn liquid passage tube 200 and a connecting joint, wherein the first end 110 of the three-way drainage tube 100 is a liquid inlet end, the second end and the third end 130 of the three-way drainage tube 100 are both liquid outlet ends, the first end 110 of the three-way drainage tube 100 is placed in the temporal horn 604 of the ventricle, and the cerebrospinal fluid in the temporal horn 604 of the ventricle can be discharged through the first end 110 of the three-way drainage tube 100 10 enters the three-way drainage tube 100, the second end 120 of the three-way drainage tube 100 is detachably connected to one end of the frontal angle liquid passage tube 200 through a connecting joint, the connecting joint is used to block / connect the second end 120 of the three-way drainage tube 100 with the frontal angle liquid passage tube 200, the other end of the frontal angle liquid passage tube 200 is placed in the frontal angle 605 of the ventricle, and the third end 130 of the three-way drainage tube 100 is used to connect to the liquid storage bag 500 located under the scalp or lead out of the scalp.

[0028] In an embodiment of the present invention, when the cerebrospinal fluid accumulated in the temporal horn 604 of the ventricle is normal, the connecting joint selects the connecting joint 300, and the cerebrospinal fluid accumulated in the temporal horn 604 of the ventricle can be normally input into the frontal horn 605 through the three-way drainage tube 100 and the frontal horn liquid tube 200, and a small amount of cerebrospinal fluid can be input into the fluid storage capsule 500 through the third end 130 of the three-way drainage tube 100; when the cerebrospinal fluid accumulated in the temporal horn 604 of the ventricle has high protein or infection, the connecting joint is replaced with a blocker 400, and the second end 120 of the three-way drainage tube 100 and the channel of the frontal horn liquid tube 200 are separated by the blocker 400, and the third end 130 of the three-way drainage tube 100 is led out of the scalp as a drainage tube for draining abnormal cerebrospinal fluid until the test is normal; in addition, it can also be used as a channel for antibiotic flushing to treat infection. After the treatment is completed, the connecting joint is changed to the connecting joint 300, and the third end 130 of the three-way flow guide tube 100 is connected to the liquid storage bag 500 under the scalp to continue the flow diversion.

[0029] like Figure 3 As shown, in an embodiment of the present invention, a frontal angle liquid passage tube 200 is provided with a plurality of side outlet holes 201 evenly distributed on the side wall at one end thereof located in the frontal angle 605 of the ventricle, and the end thereof is a round-headed cone. The end of the frontal angle liquid passage tube 200 placed in the frontal angle 605 region of the ventricle adopts a head-end-sealed side opening method. In actual operation, the head end of the frontal angle liquid passage tube 200 can be conveniently placed in the frontal angle 605 region, which effectively reduces the difficulty of operation and improves the accuracy and efficiency of placement. The plurality of side outlet holes 201 can evenly disperse and discharge the cerebrospinal fluid, avoiding the adverse effects of concentrated discharge of cerebrospinal fluid on brain tissue.

[0030] like Figure 4 As shown, in an embodiment of the present invention, a plurality of liquid inlet side holes 131 are evenly distributed on the side wall of the first end 110 of the three-way drainage tube 100, and the end thereof is a round-headed cone. The first end 110 adopts a head-end-sealed side opening method. In actual operation, the first end 110 of the three-way drainage tube 100 can be conveniently and accurately placed in the temporal angle of the ventricle, which effectively reduces the difficulty of operation and improves the accuracy and efficiency of placement; the plurality of liquid inlet side holes 131 can allow cerebrospinal fluid to quickly and evenly enter the three-way drainage tube 100, ensuring the smoothness and efficiency of cerebrospinal fluid drainage.

[0031] like Figure 5 and Figure 6As shown, the connecting joint includes a connecting joint 300 and a blocker 400 which are independently arranged from each other, wherein the blocker 400 includes a blocker body 410 of a cylindrical structure, a first joint 420 is coaxially fixedly provided at one end of the blocker body 410, and a second joint 430 is coaxially fixedly provided at the other end of the blocker body 410, the first joint 420 is detachably connected to the end of the frontal angle liquid passage tube 200 away from the frontal angle 605, and the second joint 430 is detachably connected to the second end 120 of the three-way diversion tube 100.

[0032] Specifically, the first joint 420 is inserted into the end of the frontal angle liquid passage tube 200 away from the frontal angle 605, and the connection between the first joint 420 and the end of the frontal angle liquid passage tube 200 away from the frontal angle 605 is fixed by winding with silk thread. The second joint 430 is inserted into the second end 120 of the three-way drainage tube 100, and the connection between the second joint 430 and the second end 120 of the three-way drainage tube 100 is fixed by winding with silk thread. The blocker 400 of the present invention, because the first joint 420 and the second joint 430 have a circumferential support function, can prevent the inner walls of the three-way drainage tube 100 and the frontal angle liquid passage tube 200 from fitting together when the silk thread is tied, thereby effectively controlling the tightness of the binding, avoiding leakage caused by loose binding and damage to the three-way drainage tube 100 and the frontal angle liquid passage tube 200 caused by tight binding.

[0033] like Figure 6 As shown, the first connector 420 and the second connector 430 both include a binding section 421 and a plug section 422, the two ends of the binding section 421 are respectively connected to one end of the plug section 422 and one end of the blocker body 410, the plug section 422 is a round-headed conical structure, the large-diameter end of the plug section 422 is interference fit with the inner wall of the end of the frontal angle liquid passage 200 away from the frontal angle 605 / the inner wall of the second end 120 of the three-way diversion tube 100, the binding section 421 is a cylindrical structure, and the diameter of the binding section 421 is smaller than the inner diameter of the frontal angle liquid passage 200 and the second end 120 of the three-way diversion tube 100. The plug section 422 is inserted into the second end 120 of the three-way drainage tube 100 or the frontal angle liquid passage 200, and then is tightly wrapped around the outer wall of the tube corresponding to the circumference of the binding section 421 with silk thread, thereby increasing the sealing performance of the connection between the blocker 400 and the three-way drainage tube 100 and the frontal angle liquid passage 200.

[0034] In an embodiment of the present invention, the end of the plug section 422 away from the binding section 421 is a rounded end, and the blocker body 410, the first connector 420 and the second connector 430 are an integrally formed structure, which is beneficial to improving the stability of the blocker 400.

[0035] In an embodiment of the present invention, the three-way drainage tube 100 and the frontal angle liquid passage tube 200 are provided with sealing convex rings on the inner walls cooperating with the two binding sections 421. The provision of the sealing convex rings can increase the sealing performance of the connection between the blocker 400 and the three-way drainage tube 100 and the frontal angle liquid passage tube 200.

[0036] In an embodiment of the present invention, the connecting connector 300 and the blocker 400 have similar structures, the difference being that the connecting connector 300 has a connecting hole in the central axis direction, and the specific structure is completely consistent with patent application number CN2021114781092 and patent name A connecting connector in a ventricular bypass system.

[0037] like Figure 7 As shown, the embodiment of the present invention discloses a surgical plan for the application of a bypass line for intracranial ventricle temporal horn-frontal horn shunt surgery:

[0038] Figure 7 A shows the patient in supine position, with the head rotated 60-70° to the opposite side. Figure 7 A shows a common electrode patch marking key anatomical landmarks including bilateral internal auditory canals 701, zygomatic processes 702 and the midpoint of the eyebrow arches 703;

[0039] Figure 7 B shows the patient's head in a lateral view, the first arrow 704 shows the location of the puncture point of the frontal horn of the ventricle, Kocher's point 601 (2.5 cm in front of the coronal suture and 2.5 cm lateral), and the second arrow 705 is the location of the intermediate skin incision (the midpoint of the line connecting the Frazier point and the Kocher point on the scalp);

[0040] Figure 7 C shows the lateral view of the patient, and the third arrow 706 shows that the puncture point of the temporal horn of the ventricle is Frazier's point 602 (6 cm above the external occipital protuberance and 3 cm lateral to it);

[0041] Figure 7 DE shows that the cortical path of the puncture of the temporal horn 604 of the ventricle based on the parieto-occipital approach (Frazier puncture point 602) of the present invention is smaller than the cortical path of the traditional puncture through the temporal bone (indicated by the fourth arrow 707).

[0042] The specific operation method is:

[0043] First, according to Figure 7 The bilateral internal auditory canals 701, zygomatic processes 702 and the midpoint of the eyebrow arches 703 marked by A are Figure 7 B. Determine the puncture area and cut the patient's scalp, and use the opening tool to open the skull at the frontal corner 605 and the temporal corner Frazier puncture point 602 (about 1 cm in diameter).

[0044] Then, the frontal angle liquid passage tube 200 is connected to the frontal angle 605 inside the brain along the opening of the frontal angle 605, and the first end 110 of the three-way drainage tube 100 is connected to the temporal angle inside the brain along the opening of the temporal angle;

[0045] Next, the second end 120 of the three-way drainage tube 100 and one end of the frontal angle fluid tube 200 are led to the relay incision through the subscalp tunnel, and connected at this incision through a connecting joint, so that the cerebrospinal fluid of the frontal angle 605 and the temporal angle 604 can achieve a bypass circulation under the scalp outside the skull, and the third end 130 of the three-way drainage tube 100 is connected to the fluid storage bag 500 located under the scalp.

[0046] Finally, the scalp at the puncture site and relay incision was sutured and the corresponding wound treatment was performed.

[0047] When external drainage or hypotension of the cerebrospinal fluid in the temporal horn is required, the scalp of the relay incision can be separated, the connecting connector 300 can be replaced with the blocker 400, and then the scalp of the relay incision can be sutured and the corresponding wound treatment can be performed.

[0048] An embodiment of the present invention discloses a bypass conduit for intracranial ventricular temporal horn-frontal horn shunt surgery, which adopts a three-way drainage tube, and the third end of the three-way drainage tube is used to connect to a fluid storage bag under the scalp or lead out of the scalp. The third end of the three-way drainage tube can be used to retain cerebrospinal fluid samples for testing, thereby assisting clinical diagnosis; at the same time, this end can be used to implement a fluid extraction and decompression operation to reduce intracranial pressure. For isolated temporal horns with high protein or infection, the third end of the three-way drainage tube can pass through the scalp as an external drainage tube, and the abnormal cerebrospinal fluid is drained through the external drainage tube until the test results of its various indicators are normal. In addition, the third end of the three-way drainage tube can also be used as a channel for antibiotic flushing to introduce antibiotics into the ventricular system to achieve the treatment of intracranial infection and improve the patient's clinical symptoms.

[0049] The embodiment of the present invention discloses a bypass conduit for intracranial ventricular temporal angle-frontal angle shunt surgery, which changes the traditional silk thread external tube ligation method to a method of internal tube blocking combined with external tube fixation, thereby improving the accuracy and stability of the blockage, effectively preventing cerebrospinal fluid leakage, and providing a solid guarantee for surgical prognosis. Moreover, during the entire operation, the tube wall of the double-lumen ventricular tube will not be damaged, and the original structural integrity of the ventricular tube is maintained to the greatest extent. In addition, its operation process is greatly simplified, and medical staff can quickly complete the blocking operation in just a few simple steps, greatly shortening the operation time and reducing the intraoperative risk of patients.

[0050] The technical solution of the present invention is described in detail above in conjunction with specific embodiments, and the described specific embodiments are used to help understand the concept of the present invention. Derivations and modifications made by those skilled in the art based on the specific embodiments of the present invention also fall within the protection scope of the present invention.

Claims

1. A bypass conduit for intracranial ventricular temporal horn-frontal horn shunt, characterized in that: The invention comprises a three-way drainage tube (100), a frontal angle liquid passage tube (200) and a connecting joint, wherein the first end (110) of the three-way drainage tube (100) is placed in the temporal angle (604) of the cerebral ventricle, the second end (120) of the three-way drainage tube (100) is detachably connected to one end of the frontal angle liquid passage tube (200) via the connecting joint, the connecting joint is used to block / connect the second end (120) of the three-way drainage tube (100) with the frontal angle liquid passage tube (200), the other end of the frontal angle liquid passage tube (200) is placed in the frontal angle (605) of the cerebral ventricle, and the third end (130) of the three-way drainage tube (100) is used to connect to a liquid storage bag (500) located under the scalp or to lead out of the scalp.

2. The intracranial ventriculotemporal horn-frontal horn bypass according to claim 1, characterized in that: The side wall of one end of the frontal angle liquid passage tube (200) located in the frontal angle (605) of the cerebral ventricle is evenly distributed with a plurality of liquid outlet side holes (201).

3. The intracranial ventriculotemporal-frontal horn bypass according to claim 2, characterized in that: The frontal angle fluid passage tube (200) has a rounded cone-shaped end located in the frontal angle (605) of the cerebral ventricle.

4. The intracranial ventriculotemporal horn-frontal horn bypass conduit according to claim 1, characterized in that: The side wall of the first end (110) of the three-way flow guiding pipe (100) is evenly distributed with a plurality of liquid inlet side holes (131).

5. The intracranial ventriculotemporal-frontal horn bypass conduit according to claim 4, characterized in that: The first end (110) of the three-way flow guide tube (100) is in the shape of a round cone.

6. The intracranial ventriculotemporal-frontal horn bypass conduit according to claim 1, characterized in that: The connection joint comprises a connecting joint (300) and a blocker (400) which are independently arranged from each other.

7. The intracranial ventriculotemporal-frontal horn bypass conduit according to claim 6, characterized in that: The blocker (400) comprises a blocker body (410) of a cylindrical structure, a first joint (420) being coaxially fixedly provided at one end of the blocker body (410), and a second joint (430) being coaxially fixedly provided at the other end of the blocker body (410), the first joint (420) being detachably connected to the end of the frontal angle liquid passage tube (200) away from the frontal angle (605), and the second joint (430) being detachably connected to the second end (120) of the three-way flow guide tube (100).

8. The intracranial ventriculotemporal-frontal horn bypass conduit according to claim 7, characterized in that: The first connector (420) and the second connector (430) both comprise a binding section (421) and a plug section (422); the two ends of the binding section (421) are respectively connected to one end of the plug section (422) and one end of the blocker body (410); the plug section (422) is a round-headed conical structure; the large-diameter end of the plug section (422) is interference-fitted with the inner wall of the end of the frontal angle liquid passage tube (200) away from the frontal angle (605) region / the inner wall of the second end (120) of the three-way drainage tube (100); the binding section (421) is a cylindrical structure, and the diameter of the binding section (421) is smaller than the inner diameter of the frontal angle liquid passage tube (200) and the second end (120) of the three-way drainage tube (100).

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