Nerve microvascular nerve decompression operation gasket imbedding device under direct vision

Abstract

The invention relates to an imbedding device for a nerve microvascular nerve decompression operation gasket under direct vision. The imbedding device comprises a tube assembly, a guide wire assembly, a decompression gasket and a pushing component, the tube assembly comprises a sheathing canal, a balloon and a gas transmission component, the balloon is arranged on the sheathing canal and close to the front end of the sheathing canal, and the gas transmission component is arranged on the sheathing canal and communicated with the balloon; the guide wire assembly is contained in the sheath tube, the guide wire assembly comprises a guide wire, at least two pull wires and a camera, a snake bone mechanism is arranged on the guide wire, the front end of the guide wire extends out of the front end of the sheath tube, the pull wires are connected to the snake bone mechanism, and the camera is arranged at the front end of the guide wire; the decompression gasket is of a cylindrical hollow structure and is arranged outside the sheath tube in a sleeving mode. The pushing component is arranged outside the sheathing canal in a sleeving mode and used for pushing the pressure reduction gasket towards the front end of the sheathing canal. The implantation device does not need to enter and exit from the opening repeatedly, operation of a doctor is simplified, the surgical operation difficulty is reduced, the surgical time is shortened, and the surgical risk is reduced.

Description

Technical Field

[0001] This invention relates to the field of medical device technology, and in particular to a surgical pad placement device for direct visualization of nerve microvascular decompression. Background Technology

[0002] Among cranial nerve diseases, primary trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia are common functional diseases in clinical practice. Their core characteristics are recurrent episodes of neuropathic pain or abnormal movement, which seriously impair the patient's quality of life. Their pathogenesis is based on the "vascular compression theory".

[0003] Microvascular decompression (MVD), first systematically reported by Jannetta in the 1970s, has become the gold standard procedure for treating primary TN, HFS, and GN due to its unique advantage of relieving vascular compression at the root cause. Through microsurgical techniques, decompression materials (such as polytetrafluoroethylene (PTFE) cotton or Teflon cotton) are placed between the nerve root and the compressing blood vessel, separating the vessel from the nerve. This eliminates the mechanical stimulation of the nerve by vascular pulsation, thereby repairing myelin sheath damage, restoring normal nerve electrophysiological function, and achieving a radical cure for spasm.

[0004] Microvascular decompression surgery is usually performed under general anesthesia, and the operation takes about 2-3 hours. The specific steps are as follows: 1. Positioning and incision: The patient is placed in a lateral decubitus position with the affected side facing upwards. The head is fixed with a head frame. An arc-shaped incision of about 4-5 cm is made inside the hairline behind the ear on the affected side to expose the squamous part of the occipital bone; 2. Bone window craniotomy: A bone window of about 2-3 cm in diameter is drilled in the squamous part of the occipital bone using a cranial drill ("small bone window craniotomy"), avoiding damage to the sigmoid sinus (venous sinus) and transverse sinus. If necessary, part of the mastoid air cells can be removed (tight suturing is required to prevent cerebrospinal fluid leakage); 3. Exposure of nerves and blood vessels: The dura mater is incised, and cerebrospinal fluid is slowly released. (Reduce intracranial pressure) Gently retract the cerebellar hemispheres under a microscope (avoid excessive traction that could damage the cerebellum) to expose the facial nerve root, vestibular cochlear nerve, and surrounding blood vessels, and clarify the location and course of the compressing blood vessel; 4: Vascular decompression: Use microforceps to place decompression material (Teflon cotton, approximately 1mm×2mm×3mm in size) between the compressing blood vessel and the facial nerve root, ensuring that the blood vessel is completely separated from the nerve and has no direct contact; 5: Cranial closure: After thorough hemostasis, suture the dura mater, muscles, subcutaneous tissue, and skin layer by layer. If necessary, place a drainage tube under the skin (to be removed 24-48 hours postoperatively).

[0005] In practice, the aforementioned microvascular decompression procedure requires doctors to use forceps to separate the blood vessels and nerves and place a decompression pad between them, as there are no specific tools available. The space for manual operation is very limited, which requires a high level of skill from the doctor, resulting in a difficult and time-consuming procedure. Summary of the Invention

[0006] Therefore, the purpose of this invention is to overcome the shortcomings of the prior art and provide a device for placing a surgical pad for direct visualization of nerve microvascular decompression.

[0007] This application discloses a surgical pad placement device for direct visualization of microvascular nerve decompression, comprising:

[0008] Tube assembly, guide wire assembly, pressure relief pad, and pusher component;

[0009] The tubing assembly includes a sheath, a balloon, and a gas delivery component. The balloon is disposed on the sheath and near the front end of the sheath, and the gas delivery component is disposed on the sheath and communicates with the balloon.

[0010] The guidewire assembly is housed within the sheath. The guidewire assembly includes a guidewire, traction wires, and a camera. A snake-bone mechanism is provided on the guidewire. The front end of the guidewire extends from the front end of the sheath. At least two traction wires are provided. The traction wires are connected to the snake-bone mechanism and are used to pull and adjust the bending degree of the snake-bone mechanism. The camera is located at the front end of the guidewire.

[0011] The pressure-reducing pad has a cylindrical hollow structure and is sleeved on the outside of the sheath.

[0012] The pushing component is sleeved outside the sheath and is used to push the pressure-reducing pad toward the front end of the sheath.

[0013] In one embodiment, the guide wire is a hollow tube, and the guide wire assembly also includes a data cable and a power cable electrically connected to the camera, wherein the data cable, the power cable, and the traction cable are all housed within the guide wire.

[0014] In one embodiment, the pushing component includes a hollow rod and a holding block disposed at the rear end of the hollow rod, the hollow rod being sleeved outside the sheath.

[0015] In one embodiment, the outer wall of the hollow rod is provided with an insertion port extending along its axial direction, and the hollow rod is sleeved on the outside of the sheath through the insertion port.

[0016] In one embodiment, the gas delivery component includes a gas delivery pipe and a gas delivery interface. The gas delivery pipe is disposed on the sheath and extends along the axial direction of the sheath. The gas delivery interface is disposed on the sheath and communicates with the balloon through the gas delivery pipe.

[0017] In one embodiment, the pressure-reducing gasket is made of Teflon.

[0018] In one embodiment, the sheath is a transparent plastic tube, and the hardness of the rear end of the sheath is greater than the hardness of the front end of the sheath.

[0019] This application discloses a method for placing a microvascular nerve decompression surgical pad under direct vision, which uses the microvascular nerve decompression surgical pad placement device described above. The method includes the following steps:

[0020] S1: Cut open the local skin of the patient's head, drill a hole in the exposed skull, and cut open the dura mater to form an operating opening;

[0021] S2: Using the camera at the tip of the guidewire, the tip of the guidewire is inserted into the target area through the operating port under visual conditions. The target area is the adhesion between blood vessels and nerves.

[0022] S3: Move the sheath forward along the guidewire to the target area;

[0023] S4: Gas is introduced into the balloon through the gas delivery component to inflate the balloon and separate the blood vessels and nerves into a gap;

[0024] S5: The decompression pad and the pushing component are sequentially placed over the sheath. The pushing component is operated to push the decompression pad forward along the sheath until the decompression pad is located in the gap between the blood vessel and the nerve separated by the balloon.

[0025] S6: Disengage the pusher, sheath, and guidewire assembly.

[0026] In one implementation, during step S2, when the guidewire is placed into the target area, the traction line can be pulled to adjust the curvature of the snake-bone mechanism, so that the swing angle of the front end of the guidewire can avoid the tissue and facilitate placement.

[0027] In one implementation, the operation of separating the blood vessels and nerves in step 4 is as follows: by pulling the traction line to adjust the swing angle of the guidewire tip, and then continuously outputting gas into the balloon, the adhered blood vessels and nerves can be separated.

[0028] The device in this application eliminates the need for repeated insertion and removal through the opening, greatly simplifying the surgeon's operation, reducing surgical difficulty, shortening operation time, and lowering surgical risks. This direct-vision microvascular nerve decompression surgical pad placement device features an ingenious structural design, is simple and convenient to operate, and is conducive to widespread use.

[0029] This application uses the above-mentioned method for placing a surgical pad for direct visualization of the nerve microvascular nerve decompression. The method is simple to operate, convenient to use, has low surgical difficulty, and greatly reduces the time required.

[0030] To better understand and implement this invention, the following detailed description is provided in conjunction with the accompanying drawings. Attached Figure Description

[0031] Figure 1 This is a schematic diagram of the insertion device in the embodiments of this application;

[0032] Figure 2 This is a schematic diagram of the exploded structure of the insertion device in the embodiments of this application;

[0033] Figure 3 This is a schematic diagram of the guidewire assembly (with part of the guidewire removed) in an embodiment of this application;

[0034] Figure 4 This is a schematic diagram of the tube assembly (with part of the sheath removed) in an embodiment of this application;

[0035] Figure 5 This is a schematic diagram of the structure of the pushing component in the embodiments of this application;

[0036] Figure 6 This is a schematic diagram of the operation of the direct visualization method for placing a nerve microvascular nerve decompression surgical pad in the embodiments of this application. Figure 1 ;

[0037] Figure 7 This is a schematic diagram of the operation of the direct visualization method for placing a nerve microvascular nerve decompression surgical pad in the embodiments of this application. Figure 2 ;

[0038] Figure 8 This is a schematic diagram of the operation of the direct visualization method for placing a nerve microvascular nerve decompression surgical pad in the embodiments of this application. Figure 3 ;

[0039] Figure 9 This is a schematic diagram of the operation of the direct visualization method for placing a nerve microvascular nerve decompression surgical pad in the embodiments of this application. Figure 4 ;

[0040] Figure 10 This is a schematic diagram of the operation of the direct visualization method for placing a nerve microvascular nerve decompression surgical pad in the embodiments of this application. Figure 5 ;

[0041] Figure 11 This is a schematic diagram of the operation of the direct visualization method for placing a nerve microvascular nerve decompression surgical pad in the embodiments of this application. Figure 6 ;

[0042] Explanation of reference numerals in the attached figures:

[0043] 1. Sheath; 2. Balloon; 3. Gas delivery component; 31. Gas delivery tube; 32. Gas delivery interface; 4. Guide wire; 41. Snake bone mechanism; 5. Traction line; 6. Camera; 7. Pressure relief pad; 8. Pushing component; 81. Hollow rod; 811. Insertion port; 82. Holding block; 9. Operating port; 91. Blood vessel; 92. Nerve. Detailed Implementation

[0044] To further illustrate the various embodiments, the present invention provides accompanying drawings. These drawings are part of the disclosure of the present invention, primarily used to illustrate the embodiments, and can be used in conjunction with the relevant descriptions in the specification to explain the operating principles of the embodiments. With reference to these drawings, those skilled in the art should be able to understand other possible implementations and the advantages of the present invention.

[0045] In the description of this invention, it should be understood that the terms "center," "longitudinal," "lateral," "length," "width," "thickness," "upper," "lower," "left," "right," "top," "bottom," "inner," "outer," "axial," "radial," and "circumferential" indicate the orientation or positional relationship based on the orientation or positional relationship shown in the accompanying drawings. They are used only for the convenience of describing this invention and simplifying the description, and do not indicate or imply that the device or element referred to must have a specific orientation, or be constructed and operated in a specific orientation. Therefore, they should not be understood as limiting this invention.

[0046] Please see Figures 1 to 5 This embodiment provides a device for placing a surgical pad for direct visualization of a nerve microvascular nerve decompression, including: a tube assembly, a guide wire assembly, a decompression pad 7, and a pushing component 8.

[0047] The tubing assembly includes a sheath 1, a balloon 2, and an air delivery component 3. The balloon 2 is mounted on the sheath 1 and located near its front end. The air delivery component 3 is mounted on the sheath 1 and communicates with the balloon 2. Air is delivered to the balloon 2 via the air delivery component 3 to inflate it, thereby opening up adhered blood vessels and nerves to create a gap. The sheath 1 is a transparent plastic tube for easy observation of the internal structure. The rear end of the sheath 1 is harder than the front end; in other words, the rear end is harder for easier handling, while the front end is softer to reduce damage when in contact with the patient's internal tissues.

[0048] The guidewire assembly is housed within the sheath 1 and is used to guide the movement of the sheath 1. The guidewire assembly includes a guidewire 4, a traction wire 5, and a camera 6. The guidewire 4 is equipped with a snake-bone mechanism 41, and the front end of the guidewire 4 extends from the front end of the sheath 1. At least two traction wires 5 are provided, connected to the snake-bone mechanism 41, and used to adjust the curvature of the snake-bone mechanism 41 by pulling. The camera 6 is located at the front end of the guidewire 4. The snake-bone mechanism 41 is a commonly used snake-bone structure for guidewires 4, and its curvature can be adjusted by the traction wire; therefore, the specific structure is not specifically limited here. In this embodiment, the snake-bone mechanism 41 is located at the front end of the guidewire 4, and the traction wire 5 extends along the guidewire 4 with its end extending from the rear end of the sheath 1, facilitating the doctor's manipulation of the traction wire 5.

[0049] The pressure-reducing pad 7 is a cylindrical hollow structure. The pressure-reducing pad 7 is sleeved on the outside of the sheath 1. The pressure-reducing pad 7 is used to insert into the gap between the separated blood vessels and nerves to achieve the effect of pressure reduction. The pushing component 8 is sleeved on the outside of the sheath 1 and is used to push the pressure-reducing pad 7 towards the front end of the sheath 1. By operating the pushing component 8, the pressure-reducing pad 7 can be pushed along the sheath 1 to the target area to separate the blood vessels and nerves.

[0050] During the surgery, the guidewire 4 is inserted into the patient's skull. With the aid of images captured by the camera 6, the guidewire 4 can be precisely moved to the target area (the adhesion of blood vessels and nerves). By pulling the traction line 5, the snake-bone mechanism 41 can be rotated to adjust its curvature, thereby adjusting the swing angle of the guidewire 4's tip, allowing the guidewire 4 to avoid the patient's internal tissues. Once the guidewire 4 enters the target area, the rear end of the sheath 1 can be held and moved along the guidewire 4 to the target area. Gas is introduced into the balloon 2 through the gas delivery component 3, causing the balloon 2 to inflate and open the adhered blood vessels and nerves to create a gap. Then, the pusher component 8 is used to insert the decompression pad 7 into this gap, completely separating the blood vessels and nerves, thereby achieving a decompression effect.

[0051] Using the aforementioned insertion device, during direct-vision microvascular decompression surgery, it is unnecessary to drill a large opening in the patient's skull as with existing techniques. Only a 2-3mm opening is needed for the insertion of the aforementioned components. Furthermore, the surgeon's operation only requires pulling the traction rope and pushing the guidewire 4, sheath 1, and pushing component 8, eliminating the need for repeated insertion and removal through the opening. This greatly simplifies the surgeon's operation, reduces the difficulty of the surgical procedure, shortens the operation time, and lowers the surgical risk. The direct-vision microvascular decompression surgical pad insertion device of this application has an ingenious structural design, is simple and convenient to operate, and is conducive to widespread use.

[0052] Preferably, the guide wire 4 is a hollow tube, and the guide wire assembly further includes a data cable and a power cable electrically connected to the camera 6. The data cable, power cable, and traction cable 5 are all housed within the guide wire 4. The data cable and power cable are used to transmit data from the camera 6 and to supply power to the camera 6, respectively. By making the guide wire 4 a hollow tube, the data cable, power cable, and traction cable 5 can be housed, reducing the surface wire bundle from being messy and disordered, thus simplifying the overall shape of the guide wire 4. The data cable, power cable, and traction cable 5 all extend along the length of the guide wire 4.

[0053] Preferably, the pushing component 8 includes a hollow rod 81 and a holding block 82 disposed at the rear end of the hollow rod 81, the hollow rod 81 being sleeved on the outside of the sheath 1. By holding the holding block 82, the hollow rod 81 can be pushed along the sheath 1 to push the pressure-reducing pad 7.

[0054] To facilitate the fitting of the hollow rod 81 onto the sheath tube 1, preferably, the outer wall of the hollow rod 81 is provided with an insertion port 811 extending along its axial direction. The hollow rod 81 is fitted onto the sheath tube 1 through the insertion port 811. With this configuration, it is not necessary to pull out the hollow rod 81 along the length direction of the sheath tube 1 during use. Instead, the hollow rod 81 is directly fitted onto the sheath tube 1 through the insertion port 811 along the radial direction of the sheath tube 1, simplifying the installation and disassembly of the hollow rod 81 and making it convenient to use.

[0055] Preferably, the gas delivery component 3 includes a gas delivery pipe 31 and a gas delivery interface 32. The gas delivery pipe 31 is disposed on the sheath 1 and extends axially along the sheath 1. The gas delivery interface 32 is disposed on the sheath 1 and communicates with the balloon 2 through the gas delivery pipe 31. The gas delivery interface 32 can be connected to an external air pump, which supplies gas to the gas delivery interface 32. The gas then enters the balloon 2 through the gas delivery pipe 31, causing the balloon 2 to inflate. It is understood that, to ensure the balloon 2 remains inflated, a one-way valve is provided on the gas delivery pipe 31. This one-way valve can be removed when the balloon 2 needs to be deflated.

[0056] Preferably, the pressure-reducing gasket 7 is made of Teflon.

[0057] Based on the above-mentioned direct-vision microvascular nerve decompression surgical pad placement device, please refer to Figure 6-11 As shown, this application also provides a method for placing a surgical pad for direct visualization of a microvascular nerve decompression, which uses the above-mentioned surgical pad placement device for direct visualization of a microvascular nerve decompression. The placement method includes the following steps:

[0058] S1: After making an incision in the local skin of the patient's head and drilling a hole in the exposed skull, the dura mater is cut to form an operating opening 9, as shown. Figure 6 As shown;

[0059] S2: Using the camera 6 at the tip of the guidewire 4, the tip of the guidewire 4 is inserted into the target area through the operating port under visual guidance. The target area is the adhesion point between the blood vessel 91 and the nerve 92. Figure 7 As shown;

[0060] S3: Move the sheath 1 forward along the guide wire 4 to the target area, such as... Figure 8 As shown;

[0061] S4: Gas is introduced into the balloon 2 through the gas delivery component 3, causing the balloon 2 to inflate and separate the blood vessel 91 and nerve 92 into a gap, such as... Figure 9 As shown;

[0062] S5: Place the pressure-reducing pad 7 and the pushing component 8 sequentially over the sheath 1. Operate the pushing component 8 to push the pressure-reducing pad 7 forward along the sheath 1 until the pressure-reducing pad 7 is located within the gap between the blood vessel 91 and the nerve 92 separated by the balloon 2. Figure 10 As shown;

[0063] S6: Withdraw the pusher component 8, sheath 1, and guidewire assembly, such as Figure 11 As shown.

[0064] Specifically, in step S2, during the process of placing the guidewire 4 into the target area, the traction line 5 can be pulled to adjust the degree of bending of the snake bone mechanism 41, so that the swing angle of the front end of the guidewire 4 can avoid the tissue and facilitate placement.

[0065] Specifically, in step 4, the operation of separating the blood vessels and nerves to create a gap is as follows: by pulling the traction line 5 to adjust the swing angle of the guide wire 4, and then continuously outputting gas to the balloon 2, the adhered blood vessels and nerves can be separated.

[0066] The above-mentioned method for placing a surgical pad for direct-vision microvascular nerve decompression is simple to operate, convenient to use, has low surgical difficulty, and greatly reduces the time required.

[0067] The embodiments described above are merely examples of several implementations of the present invention, and while the descriptions are specific and detailed, they should not be construed as limiting the scope of the invention. It should be noted that those skilled in the art can make various modifications and improvements without departing from the concept of the present invention, and these modifications and improvements all fall within the scope of protection of the present invention.

Claims

1. A device for placing a surgical pad for direct visualization of microvascular nerve decompression, characterized in that, include: Tube assembly, guide wire assembly, pressure relief pad, and pusher component; The tubing assembly includes a sheath, a balloon, and a gas delivery component. The balloon is disposed on the sheath and near the front end of the sheath, and the gas delivery component is disposed on the sheath and communicates with the balloon. The guidewire assembly is housed within the sheath. The guidewire assembly includes a guidewire, traction wires, and a camera. A snake-bone mechanism is provided on the guidewire. The front end of the guidewire extends from the front end of the sheath. At least two traction wires are provided. The traction wires are connected to the snake-bone mechanism and are used to pull and adjust the bending degree of the snake-bone mechanism. The camera is located at the front end of the guidewire. The pressure-reducing pad has a cylindrical hollow structure and is sleeved on the outside of the sheath. The pushing component is sleeved outside the sheath and is used to push the pressure-reducing pad toward the front end of the sheath.

2. The device for placing a surgical pad for direct visualization of microvascular nerve decompression surgery according to claim 1, characterized in that: The guide wire is a hollow tube, and the guide wire assembly also includes a data cable and a power cable electrically connected to the camera. The data cable, power cable, and traction cable are all housed within the guide wire.

3. The device for placing a surgical pad for direct visualization of microvascular nerve decompression surgery according to claim 1, characterized in that: The pushing component includes a hollow rod and a holding block disposed at the rear end of the hollow rod, the hollow rod being sleeved outside the sheath.

4. The device for placing a surgical pad for direct visualization of microvascular nerve decompression surgery according to claim 3, characterized in that: The outer wall of the hollow rod is provided with an insertion port extending along its axial direction, and the hollow rod is sleeved on the outside of the sheath tube through the insertion port.

5. The device for placing a surgical pad for direct visualization of microvascular nerve decompression surgery according to claim 1, characterized in that: The gas delivery component includes a gas delivery pipe and a gas delivery interface. The gas delivery pipe is disposed on the sheath and extends along the axial direction of the sheath. The gas delivery interface is disposed on the sheath and communicates with the balloon through the gas delivery pipe.

6. The device for placing a surgical pad for direct visualization of microvascular nerve decompression surgery according to any one of claims 1-5, characterized in that: The pressure-reducing gasket is made of Teflon.

7. The device for placing a surgical pad for direct visualization of microvascular nerve decompression surgery according to any one of claims 1-5, characterized in that: The sheath is a transparent plastic tube, and the hardness of the rear end of the sheath is greater than that of the front end of the sheath.

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