Direct vision nerve microvascular neurolysis pad placement device

Abstract

The present application relates to a kind of direct vision nerve microvascular nerve decompression operation pad insertion device, and insertion device includes: tube component, guide wire component, decompression pad and push part;Tube component includes sheath tube, balloon and gas delivery component, balloon is set on sheath tube and is close to the front end of sheath tube, gas delivery component is set on sheath tube and is communicated with balloon;Guide wire component is housed in sheath tube, guide wire component includes guide wire, traction line and camera, guide wire is set up snake bone mechanism, the front end of guide wire is stretched from the front end of sheath tube, traction line is at least set up as two, traction line is connected to snake bone mechanism, camera is set to the front end of guide wire;Decompression pad is cylindrical hollow structure, and decompression pad is sleeved on the outside of sheath tube;Push part is sleeved on the outside of sheath tube, for pushing decompression pad towards the front end of sheath tube direction.This application insertion device does not need to repeatedly from opening in and out, simplify the operation of doctor, reduce the operation difficulty, reduce the operation time and reduce the risk of operation.

Description

TECHNICAL FIELD

[0001] The present application relates to the technical field of medical devices, in particular to a direct vision nerve microvascular nerve decompression operation pad placement device. BACKGROUND

[0002] Among cranial nerve diseases, primary trigeminal neuralgia, facial spasm and glossopharyngeal neuralgia are common functional diseases, and their core features are recurrent neuropathic pain or abnormal movement, which seriously damages the quality of life of patients, and their pathogenesis is centered on the "vascular compression theory".

[0003] Microvascular decompression (MVD) has become the gold standard for treating primary TN, HFS and GN since it was first systematically reported by Jannetta in the 1970s, with the unique advantage of "targeting the cause to relieve vascular compression". Through microsurgical techniques, a decompression material (such as Teflon cotton) is placed between the nerve root and the compressing blood vessel to separate the blood vessel from the nerve and eliminate the mechanical stimulation of the blood vessel pulsation on the nerve, thereby repairing the nerve myelin sheath damage, restoring the normal electrophysiological function of the nerve, and achieving the purpose of curing spasm.

[0004] Microvascular decompression is usually performed under general anesthesia, and the operation time is about 2-3 hours, and the specific steps are as follows: 1: body position and incision: the patient takes a lateral position with the affected side facing up, the head frame is fixed to the head, and an arc-shaped incision about 4-5 cm long is made inside the hairline on the affected side, exposing the squamous part of the occipital bone; 2: bone window craniotomy: a bone window with a diameter of about 2-3 cm is drilled on the squamous part of the occipital bone using a skull drill ("small bone window craniotomy"), avoiding damage to the sigmoid sinus (venous sinus) and transverse sinus, and if necessary, part of the mastoid air cell can be removed (it needs to be sutured tightly to prevent cerebrospinal fluid leakage); 3: expose the nerve and blood vessels: incise the dura mater, slowly release the cerebrospinal fluid (lower the intracranial pressure), gently pull the cerebellar hemisphere under the microscope (avoid excessive pulling leading to cerebellar injury), expose the facial nerve root, vestibulocochlear nerve and surrounding blood vessels, and determine the location and course of the compressing blood vessels; 4: vascular decompression: use microforceps to place decompression material (Teflon cotton, about 1mm x 2mm x 3mm) between the compressing blood vessel and the facial nerve root, ensuring that the blood vessel is completely separated from the nerve without direct contact; 5: close the skull: after thorough hemostasis, layer by layer suture the dura mater, muscle, subcutaneous tissue and skin, and if necessary, place a drainage tube under the skin (remove it 24-48 hours after surgery).

[0005] The above-mentioned microvascular decompression in the actual operation process, without the use of specific tools, the doctor needs to use the forceps tool to separate the blood vessel and the nerve and place the decompression pad in the gap between them, and the manual operation space is very limited, which requires high operation requirements of the doctor, resulting in high difficulty and long operation time of the operation. SUMMARY

[0006] Based on this, the purpose of the present application is to overcome the deficiencies of the prior art, provide a direct vision nerve microvascular nerve decompression surgical spacer placement device,

[0007] The direct vision nerve microvascular nerve decompression surgical spacer placement device of the present application comprises:

[0008] The tube assembly, the guide wire assembly, the decompression spacer and the pushing component;

[0009] The tube assembly comprises a sheath tube, a balloon and a gas delivery component, the balloon is arranged on the sheath tube and close to the front end of the sheath tube, and the gas delivery component is arranged on the sheath tube and communicated with the balloon;

[0010] The guide wire assembly is accommodated in the sheath tube, the guide wire assembly comprises a guide wire, a traction line and a camera, the guide wire is provided with a snake mechanism, the front end of the guide wire extends from the front end of the sheath tube, the traction line is arranged as at least two, the traction line is connected to the snake mechanism for adjusting the bending degree of the snake mechanism, and the camera is arranged at the front end of the guide wire;

[0011] The decompression spacer is a cylindrical hollow structure, and the decompression spacer is sleeved outside the sheath tube;

[0012] The pushing component is sleeved outside the sheath tube and used for pushing the decompression spacer towards the front end of the sheath tube.

[0013] As an embodiment, the guide wire is a hollow tube, the guide wire assembly further comprises a data line and a power line electrically connected to the camera, and the data line, the power line and the traction line are all accommodated in the guide wire.

[0014] As an embodiment, the pushing component comprises a hollow rod and a holding block arranged at the rear end of the hollow rod, and the hollow rod is sleeved outside the sheath tube.

[0015] As an embodiment, the outer wall of the hollow rod is provided with a placing opening extending along the axial direction thereof, and the hollow rod is sleeved outside the sheath tube through the placing opening.

[0016] As an embodiment, the gas delivery component comprises a gas delivery tube and a gas delivery interface, the gas delivery tube is arranged on the sheath tube and extends along the axial direction of the sheath tube, and the gas delivery interface is arranged on the sheath tube and communicated with the balloon through the gas delivery tube.

[0017] As an embodiment, the material of the decompression spacer is 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] For better understanding and implementation, the present application is described in detail below in conjunction with the drawings. BRIEF DESCRIPTION OF DRAWINGS

[0031] Figure 1 Structure diagram of the implanting device in the embodiment of the present application;

[0032] Figure 2 Structure diagram of the implanting device in the embodiment of the present application;

[0033] Figure 3 Structure diagram of the implanting device in the embodiment of the present application;

[0034] Figure 4 Structure diagram of the implanting device in the embodiment of the present application;

[0035] Figure 5 Structure diagram of the implanting device in the embodiment of the present application;

[0036] Figure 6 Operation diagram of the method for implanting the surgical patch under direct vision in the embodiment of the present application Figure 1 ;

[0037] Figure 7 Operation diagram of the method for implanting the surgical patch under direct vision in the embodiment of the present application Figure 2 ;

[0038] Figure 8 Operation diagram of the method for implanting the surgical patch under direct vision in the embodiment of the present application Figure 3 ;

[0039] Figure 9 Operation diagram of the method for implanting the surgical patch under direct vision in the embodiment of the present application Figure 4 ;

[0040] Figure 10 Operation diagram of the method for implanting the surgical patch under direct vision in the embodiment of the present application Figure 5 ;

[0041] Figure 11 Operation diagram of the method for implanting the surgical patch under direct vision in the embodiment of the present application Figure 6 ;

[0042] BRIEF DESCRIPTION OF DRAWINGS

[0043] 1, sheath; 2, balloon; 3, gas delivery component; 31, gas delivery tube; 32, gas delivery port; 4, guide wire; 41, snake mechanism; 5, traction line; 6, camera; 7, decompression pad; 8, pushing component; 81, hollow rod; 811, insertion port; 82, holding block; 9, operation port; 91, blood vessel; 92, nerve. DETAILED DESCRIPTION

[0044] To further illustrate the embodiments, the present application provides drawings. These drawings are part of the disclosure of the present application, which mainly serves to illustrate the embodiments, and can be explained in conjunction with the related description of the specification to explain the operating principle of the embodiments. With reference to these contents, those skilled in the art should understand other possible implementations and advantages of the present application.

[0045] In the description of the present application, it should be understood that the terms "center", "longitudinal", "transverse", "length", "width", "thickness", "upper", "lower", "left", "right", "top", "bottom", "inner", "outer", "axial", "radial", "circumferential" and the like indicate the orientation or positional relationship based on the orientation or positional relationship shown in the drawings, and are only for the convenience of describing the present application and simplifying the description, and therefore cannot be understood as indicating or implying that the devices or elements referred to must have a particular orientation, be constructed and operated in a particular orientation, and therefore cannot be understood as limiting the present application.

[0046] Please refer to Figures 1 to 5 The present embodiment provides a direct vision nerve microvascular nerve decompression operation pad insertion device, which comprises a tube assembly, a guide wire assembly, a decompression pad 7 and a pushing component 8.

[0047] The tube assembly comprises a sheath 1, a balloon 2 and a gas delivery component 3, the balloon 2 is arranged on the sheath 1 and close to the front end of the sheath 1, and the gas delivery component 3 is arranged on the sheath 1 and communicates with the balloon 2. Gas can be delivered to the balloon 2 through the gas delivery component 3 to make the balloon 2 expand and become larger, so as to open the adhered blood vessels and nerves to form a gap. Wherein, the sheath 1 is a transparent plastic tube, which is convenient for observing the situation in the tube, and the hardness of the rear end of the sheath 1 is greater than that of the front end of the sheath 1, in other words, the rear end of the sheath 1 is harder, which is convenient for holding operation, and the front end is softer, which reduces the damage when contacting the tissue in the patient's body.

[0048] The guide wire assembly is accommodated in the sheath tube 1 for guiding the movement of the sheath tube 1, wherein the guide wire assembly comprises a guide wire 4, a traction line 5 and a camera 6, the guide wire 4 is provided with a snake bone mechanism 41, the front end of the guide wire 4 extends from the front end of the sheath tube 1, the traction line 5 is provided with at least two, the traction line 5 is connected to the snake bone mechanism 41 for pulling and adjusting the bending degree of the snake bone mechanism 41, and the camera 6 is arranged at the front end of the guide wire 4. Wherein the snake bone mechanism 41 is a snake bone structure commonly used for the guide wire 4, and the bending degree thereof can be adjusted by a traction rope, so the specific structure is not limited here. In the embodiment, the snake bone mechanism 41 is located at the front end of the guide wire 4, the traction line 5 extends along the guide wire 4, and the end of the traction line 5 extends from the rear end of the sheath tube 1, which is convenient for the doctor to operate the traction line 5.

[0049] Wherein, the decompression gasket 7 is a cylindrical hollow structure, the decompression gasket 7 is sleeved outside the sheath tube 1, the decompression gasket 7 is used to be placed in the gap between the separated blood vessels and nerves to achieve the effect of decompression, the pushing component 8 is sleeved outside the sheath tube 1, used to push the decompression gasket 7 towards the front end of the sheath tube 1, by operating the pushing component 8, the decompression gasket 7 can be pushed along the sheath tube 1 to the target area to separate the blood vessels and nerves.

[0050] When performing surgery, the guide wire 4 is stretched into the patient's head, under the assistance of the image shot by the camera 6, the guide wire 4 can be accurately moved to the target area (the adhesion place of blood vessels and nerves), by pulling the traction line 5, the snake bone mechanism 41 can be driven to rotate to adjust the bending degree, and then the swinging angle of the front end of the guide wire 4 is adjusted, so that the guide wire 4 can avoid the tissues in the patient's body. When the guide wire 4 enters the target area, the rear end of the sheath tube 1 can be held, the sheath tube 1 is moved along the guide wire 4 to the target area, the gas in the balloon 2 is inputted by the gas inputting component 3, the balloon 2 is inflated to separate the adhered blood vessels and nerves to form a certain gap, then the decompression gasket 7 is sent into the gap by operating the pushing component 8, so that the blood vessels and nerves are completely separated, thereby achieving the effect of decompression.

[0051] By using the above placement device, when performing the direct vision nerve microvascular nerve decompression surgery, a larger opening does not need to be drilled in the patient's head as in the prior art, only a 2-3mm opening is needed for the above components to extend into, and the doctor only needs to pull the traction rope and push the guide wire 4, the sheath tube 1 and the pushing component 8, without repeatedly going in and out of the opening, which greatly simplifies the operation of the doctor, reduces the difficulty of the operation, reduces the operation time and reduces the risk of the operation. The direct vision nerve microvascular nerve decompression surgery gasket placement device has a clever structure design, is simple and convenient to operate, and is conducive to popularization and use.

[0052] Preferably, the guide wire 4 is a hollow tube, the guide wire assembly further comprises a data line and a power line electrically connected to the camera 6, and the data line, the power line and the traction line 5 are all accommodated in the guide wire 4. The data line and the power line are respectively used for transmitting data of the camera 6 and supplying power to the camera 6. By setting the guide wire 4 as a hollow tube, the data line, the power line and the traction line 5 can be accommodated, the surface wire harness is tidy, and the overall appearance of the guide wire 4 is simple. The data line, the power line and the traction line 5 are all arranged along the length direction of the guide wire 4.

[0053] Preferably, the pushing component 8 comprises a hollow rod 81 and a holding block 82 arranged at the rear end of the hollow rod 81, and the hollow rod 81 is sleeved outside the sheath tube 1. By holding the holding block 82, the hollow rod 81 can be pushed along the sheath tube 1 to push the decompression gasket 7.

[0054] In order to facilitate the hollow rod 81 to be sleeved outside the sheath tube 1, preferably, an insertion port 811 extending along the axial direction of the hollow rod 81 is arranged on the outer wall of the hollow rod 81, and the hollow rod 81 is sleeved outside the sheath tube 1 through the insertion port 811. In this way, when in use, the hollow rod 81 does not need to be pulled out along the length direction of the sheath tube 1, but is directly sleeved outside the sheath tube 1 along the radial direction of the sheath tube 1 through the insertion port 811, so that the installation and dismounting operations of the hollow rod 81 are simplified, and the use is facilitated.

[0055] Preferably, the gas conveying component 3 comprises a gas conveying pipe 31 and a gas conveying interface 32, the gas conveying pipe 31 is arranged on the sheath tube 1 and extends along the axial direction of the sheath tube 1, and the gas conveying interface 32 is arranged on the sheath tube 1 and is communicated with the balloon 2 through the gas conveying pipe 31. The gas conveying interface 32 can be connected to an external air pump, the air pump inputs gas into the gas conveying interface 32, and the gas enters the balloon 2 through the gas conveying pipe 31 to inflate the balloon 2. It can be understood that, in order to ensure that the balloon 2 is in an inflated state, a one-way air valve is arranged on the gas conveying pipe 31, and the one-way air valve can be dismounted when it is needed to deflate the balloon 2.

[0056] Preferably, the material of the decompression gasket 7 is Teflon.

[0057] Based on the above-mentioned device for placing a gasket in a direct vision nerve microvessel nerve decompression operation, the device can be used for placing a gasket in a direct vision nerve microvessel nerve decompression operation, and the device can be used for placing a gasket in a direct vision nerve microvessel nerve decompression operation. Figures 6-11 The application also provides a method for placing a gasket in a direct vision nerve microvessel nerve decompression operation, which uses the above-mentioned device for placing a gasket in a direct vision nerve microvessel nerve decompression operation, and the placing method comprises the following steps:

[0058] S1: The local skin of the head of a patient is incised, a hole is drilled in the exposed skull, and the dura mater is incised to form an operation port 9, as shown in Figure 6 ;

[0059] S2: the front end of the guide wire 4 is placed into the target area under visual condition by the camera 6 at the front end of the guide wire 4, the target area is the adhesion between the blood vessel 91 and the nerve 92, as shown in the figure; Figure 7 .

[0060] S3: the sheath tube 1 is moved forward along the guide wire 4 to the target area, as shown in the figure; Figure 8 .

[0061] S4: the balloon 2 is inflated by inputting gas into the balloon 2 through the gas input component 3 to separate the blood vessel 91 and the nerve 92 to form a gap, as shown in the figure; Figure 9 .

[0062] S5: the decompression pad 7 and the pushing component 8 are sequentially sleeved outside the sheath tube 1, and the pushing component 8 is operated to push the decompression pad 7 forward along the sheath tube 1 until the decompression pad 7 is located in the gap between the blood vessel 91 and the nerve 92 separated by the balloon 2, as shown in the figure; Figure 10 .

[0063] S6: the pushing component 8, the sheath tube 1 and the guide wire assembly are withdrawn, as shown in the figure. Figure 11 .

[0064] Specifically, in the step S2, the pulling line 5 is pulled to adjust the bending degree of the snake mechanism 41 during the placement of the guide wire 4 into the target area, so that the swing angle of the front end of the guide wire 4 is adjusted to facilitate the placement by avoiding the tissues.

[0065] Specifically, in the step S4, the adhesion between the blood vessel and the nerve is separated by pulling the pulling line 5 to adjust the swing angle of the front end of the guide wire 4 and continuously outputting gas to the balloon 2.

[0066] The above-mentioned direct vision nerve microvascular nerve decompression operation pad placement device placement method is simple to operate, convenient to use, low in operation difficulty and greatly reduces the operation time.

[0067] The above-mentioned embodiments only express several embodiments of the present application, the description is more specific and detailed, but it cannot be understood as the limitation of the scope of the application. It should be pointed out that for ordinary skilled in the art, without departing from the concept of the present application, a number of modifications and improvements can be made, which belong to the protection scope of the present application.

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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