Instrument for orbital endoscopic surgery

Abstract

An instrument for an orbital endoscopic surgery is presented. The instrument comprises: a handle; a support element to which the handle is movably attached at one end; a first arm and a second arm, each arm comprising a fixing portion connecting the arm to the support element, and an anchoring portion releasably attached to the fixing portion, one of the anchoring portions configured to anchor to a first fissure of the orbital cavity, and the other of the anchoring portions configured to anchor to a second fissure of the orbital cavity. One of the anchoring portions is configured to be anchored to a first fracture of the orbital cavity, and the other of the anchoring portions is configured to be anchored to a second fracture of the orbital cavity, each of the anchoring portions having a given curvature; a mesh disposed between the anchoring portions and connected to each of the anchoring portions to aggregate periorbital tissue when the anchoring portions are anchored to the first fracture and the second fracture; and a sensor for detecting the applied pressure applied to the first fracture and the second fracture.

Description

Technical Field

[0001] This invention relates to an instrument / device for transorbital endoscopic surgery. Background Technology

[0002] Transorbital endoscopic surgery is a minimally invasive surgical technique that involves accessing the skull and orbital region through the eye socket using an endoscope and specialized instruments. This method is used to treat a variety of conditions and lesions in the skull base, sinuses, and orbit.

[0003] Orbital endoscopic surgery is considered minimally invasive because it involves making a small incision in the eyelid to access the surgical site. This approach reduces the need for extensive tissue dissection, thereby minimizing trauma to surrounding structures and shortening recovery time.

[0004] In addition, it is used to treat a wide range of conditions, including complex skull base tumors (benign or malignant), cysts, vascular abnormalities, inflammatory diseases, and congenital anomalies in the skull base, sinuses, and orbit.

[0005] Compared to traditional open surgery, transorbital endoscopic surgery offers advantages including reduced scarring, shorter hospital stays, and faster recovery. It also minimizes the risk of damage to vital structures.

[0006] To reach the base of the skull, one of the first procedures is to reposition the contents of the orbit. Currently, surgeons use deformable, uncontrolled retractors to achieve this. Moreover, during the procedure, the optic nerve is subjected to pressure that could damage it, and currently the only way to measure this pressure is by measuring the diameter of the pupil, which requires stopping the surgery and does not allow for the prevention of visual impairment.

[0007] Therefore, new and improved instruments / devices are needed for transorbital endoscopic surgery, especially those related to displacement of orbital contents, in order to reach the skull base. Summary of the Invention

[0008] Therefore, the object of this invention is to provide a novel instrument / device for transorbital endoscopic surgery that allows the orbital contents to be moved aside once an incision is made. This is necessary to create a highly desirable working space and to introduce surgical instruments through it. Moreover, the proposed instrument allows for the measurement of intraocular pressure without stopping the surgery and can prevent increases in orbital pressure that could lead to postoperative visual impairment.

[0009] To this end, according to one aspect, the present invention provides an instrument for transorbital endoscopic surgery, comprising: a handle; a support element, the handle being movably attached at one end to the support element; a first arm and a second arm, each arm including a fixed portion connecting the arm to the support element and an anchoring portion releasably attached to the fixed portion, one of the anchoring portions being configured to anchor to a first slit in the orbital cavity, specifically, the inferior orbital slit (i.e., a very constant and relevant anatomical landmark for endoscopic transorbital surgery of the skull base), and the other of the anchoring portions being configured to anchor to a second slit in the orbital cavity, specifically, the superior orbital slit (i.e., a second and very constant anatomical landmark for endoscopic transorbital surgery of the skull base), each anchoring portion including a given curvature; a mesh disposed between and connected to each of the anchoring portions to gather around the orbit when the anchoring portions are anchored to the first and second slits; and a sensor for detecting pressure applied to the first and second slits when the mesh gathers around the orbit.

[0010] According to the invention, at least one fixed portion further includes a motion mechanism configured to allow controlled reciprocating telescopic movement of its respective anchoring portion. In some specific embodiments, both fixed portions include motion mechanisms.

[0011] In some embodiments, the sensor is arranged on the mesh, making the mesh a sensorized mesh. Alternatively, in other embodiments, the sensor is arranged on the anchoring portion. Even in some embodiments, the sensor may be arranged on both the mesh and the anchoring portion.

[0012] In some embodiments, the motion mechanism includes a guide and a sliding mechanism, the sliding mechanism being configured to slide via the guide.

[0013] In some embodiments, the handle includes a pivoting element at the end where it is connected to the support element.

[0014] In some embodiments, the handle further includes a push button that allows the handle to rotate from an initial position to a final position along at least one axis, such that when the handle is in the final position, the angle between the handle and the first and second arms can reach up to 180°.

[0015] In some embodiments, the support element further includes a toothed control wheel for opening and closing the first arm and the second arm.

[0016] In some embodiments, the support element is also equipped with a push button designed to suddenly / immediately close both the first and second arms. This function is achieved through the coordinated action of the push button and an integrated braking mechanism and worm gear within the support element. Therefore, when the push button on the support element engages, the arms in the open position can close quickly and effectively. This feature is particularly important during surgery because it allows surgeons to expedite the arm closure process, especially when there may not be sufficient time to manually operate the toothed control wheels. Thus, this alternative closure mechanism for the arms provides a fast and efficient solution.

[0017] According to the present invention, the mesh element may be made of or contain a biocompatible material or coating. In some specific embodiments, the mesh element is made of a biocompatible polymer, such as PEDOT:PSS (poly(3,4-ethylenedioxythiophene)-poly(styrene sulfonate)), PVDF (polyvinylidene fluoride), P3HT (poly(3-hexylthiophene)), etc.

[0018] In some embodiments, the first and second arms are made of stainless steel.

[0019] In some embodiments, the sensor is configured to transmit the detected pressure to a computer device. This can be done wirelessly or via cable.

[0020] In some embodiments, the device may further include a communication module / element, which is preferably arranged / disposed within the support element. The communication module / element can receive detected pressure values ​​from sensors, either via cable or wirelessly. Attached Figure Description

[0021] The foregoing and other advantages and features will be more fully understood from the following detailed description of the embodiments, taken in conjunction with the accompanying drawings, which should be considered as being given in an illustrative and non-limiting manner, wherein:

[0022] Figure 1A and Figure 1B These are different views of an instrument for transorbital endoscopic surgery according to an embodiment of the present invention.

[0023] Figure 2A and Figure 2B An embodiment according to the present invention is shown. Figure 1A-1B Another view of the instrument, specifically showing the rotation of the handle on at least one axis.

[0024] Figure 3 An enlarged view is shown of a motion mechanism included in the fixed part of the proposed device to allow controlled reciprocating telescopic movement of the fixed part.

[0025] Figure 4 An enlarged view is shown of the braking mechanism and worm gear assembly that work in conjunction with a push button on a support element to abruptly close the arm of the instrument. Detailed Implementation

[0026] Figure 1A and Figure 1B An embodiment of the proposed inventive architecture is shown. According to this embodiment, the device includes a handle 10, a support element 11 with a push button (or quick-close button) 12 and a toothed control wheel 13, two arms 20, 30, a mesh 40, and a sensor (not shown), particularly a pressure sensor or the like.

[0027] In this particular embodiment, the handle 10 is connected or secured to the support element 11 via a pivoting mechanism or element 15. This pivoting element 15 allows the handle to rotate about at least one axis, thereby enhancing the ergonomics of the device. Initially, the handle 10 is positioned almost perpendicularly relative to the arms 20, 30; however, it can be rotated to adjust the angle between the handle 10 and the arms 20, 30 to approximately 180 degrees (e.g., ...). Figure 2A and Figure 2B (As shown). The change of handle 10 from the initial position (90°) to the final position (180°) is achieved by using a push button (or handle movement button) 9 provided on handle 10.

[0028] Specifically, arms 20 and 30 are made of stainless steel. It should be noted that in other embodiments not shown, the device may include more than two arms.

[0029] Each of the two arms 20, 30 is formed by a fixed portion 21, 31 connected to the support element 11 and an anchoring portion 22, 32 releasably attached to its corresponding fixed portion 21, 31. That is, the anchoring portions are interchangeable / replaceable.

[0030] Each of the anchoring portions 22 and 32 includes a given curvature and has a geometry designed to adapt to the anatomy of the periorbital region and preserve the maximum surface area of ​​the periorbital region, and to allow the anchoring portions 22 and 32 to be anchored to the first (or inferior) orbital fissure and the second (or superior) orbital fissure, respectively. That is, the anchoring portions 22 and 32 are used to guide the surgeon during surgery and serve as anchoring points for each arm 20 and 30. When the instrument is inserted into the orbital region, the first or inferior fissure is first identified, and because it begins earlier, one of the arms 20 and 30 will be anchored therein. The instrument will continue to be inserted, and when the second fissure becomes visible, it will also be anchored therein. When both arms 20 and 30 are closed, the insertion space of the instrument should be as minimal as possible (maximum approximately 10 mm).

[0031] A mesh 40, made of or including a biocompatible material or coating, is attached to each of the anchoring portions 22, 32 to gather around the orbit when the anchoring portions 22, 32 are anchored to the first and second slits.

[0032] In some embodiments, the sensor is arranged / positioned on the mesh 40 (i.e., the mesh 40 is a sensorized mesh). Alternatively, the sensor is arranged / positioned on or on the anchoring portions 22, 32, or both (i.e., on the mesh and the anchoring portions). The sensor allows for real-time monitoring of whether the pressure applied to the first and second slits is correct. Data from the sensor can be transmitted via cable or wireless connection to a computer device, etc. In a particular embodiment, data from the sensor is transmitted to a communication module / element arranged within the support element 11 and connected to the sensor via cable. The data is then forwarded from this communication module / element to a computer device such as a PC, cloud server, etc. Therefore, the received pressure measurements can be stored for future research and / or used to create pressure maps to assist surgeons or specialists in future transorbital endoscopic surgical procedures.

[0033] Continue to Figure 1A and Figure 1B To explain, according to this embodiment, each of the fixed portions 21, 31 includes a motion mechanism 50 (see...). Figure 3 To obtain an enlarged view of it, so that its corresponding anchoring portions 22, 32 can perform controlled forward and backward telescopic movements. It should be noted that in other embodiments not shown, only one of the fixed portions 21, 31 is provided with the motion mechanism 50.

[0034] Specifically, the motion mechanism 50 includes a guide 51 and a sliding mechanism 52 for sliding via the guide 51. Therefore, the motion mechanism 50 allows for precise extension and retraction of the anchoring portions 22, 32, because the movement is controlled; that is, by pressing the sliding mechanism 52, the brakes holding the anchoring portions 22, 32 in place are released, and they can be extended or retracted. When the button is released, the brakes are activated, and the anchoring portions 22, 32 are secured. In this way, the movement and control of the anchoring portions 22, 32 are achieved separately without requiring continuous application of pressure.

[0035] Regarding the toothed control wheel 13, this element allows for controlled (horizontal) opening and closing of the two arms 20, 30. The toothed control wheel 13 operates in conjunction with the worm gear assembly 17. This opening and control system enables the transmission of rotational to linear motion: if the gear 13 rotates, its teeth engage with the rings of the worm gear assembly 17. As it rotates, the worm gear assembly 17 moves in a linear direction because the helix causes the worm gear assembly 17 to move along its axis. This allows the rotational motion of the toothed control wheel 13 to be converted into the linear motion of the worm gear assembly 17. The motion can be controlled by a braking mechanism 18 with brakes disposed on each arm 20, 30. This braking mechanism 18 is responsible for opening and closing the arms as the toothed control wheel 13 rotates in a controlled manner.

[0036] In addition, braking mechanism 18 is also responsible for the rapid (or immediate) closing of arms 20 and 30. In this regard, such as... Figure 4 As can be seen, the braking mechanism 18 is connected to the quick-closing button 12. By means of a spring system (not shown), when the quick-closing button 12 is pressed, the brake of the braking mechanism 18 is released. Thus, if the button is not pressed, the only way to move the arms 20, 30 is by rotating the toothed control wheel 13. When the quick-closing button 12 is pressed, the brake is released and the spring stops the brake from pressing against the worm gear assembly 17, thereby closing the arms 20, 30 to their initial width.

[0037] Unless otherwise indicated, all figures expressing measurements, conditions, etc., used in this specification and claims should be understood to be modified by the term "about" in all cases. Therefore, unless otherwise stated, the numerical parameters set forth in this specification and the appended claims are approximate values ​​that may vary depending on the desired properties desired by the patient subject matter disclosed herein.

[0038] As used herein, the term “about”, when referring to a value or amount of length, width, mass, weight, temperature, time, volume, concentration, percentage, etc., means including a difference of ±20% in some embodiments, ±10% in some embodiments, ±5% in some embodiments, ±1% in some embodiments, ±0.5% in some embodiments, and ±0.1% in some embodiments compared to a defined amount, because such variation is suitable for performing the disclosed method or using the disclosed composition.

[0039] The above embodiments should be understood as several illustrative examples of the present invention. Those skilled in the art will understand that various modifications, combinations, and changes can be made to the embodiments without departing from the scope of the invention. In particular, different partial solutions from different embodiments can be combined in other configurations where technically feasible.

[0040] The scope of this invention is defined in the following claims.

Claims

1. Instruments used in transorbital endoscopic surgery, including: Handle (10); A support element (11), wherein the handle (10) is movably attached to the support element (11) at one end; A first arm (20) and a second arm (30), each arm including a fixed portion (21, 31) and an anchoring portion (22, 32), the fixed portion connecting the arm to the support element (11), the anchoring portion being releasably attached to the fixed portion (21, 31), one of the anchoring portions (22, 32) being configured to anchor to a first slit in the orbital cavity, and the other of the anchoring portions (22, 32) being configured to anchor to a second slit in the orbital cavity, each of the anchoring portions (22, 32) including a given curvature; A mesh (40) is arranged between and connected to each of the anchoring portions (22, 32) to gather around the periorbital area when the anchoring portions (22, 32) are anchored to the first and second slits; as well as Multiple sensors are configured to detect pressure applied to the first and second slits when the mesh (40) is gathered around the periorbital area.

2. The apparatus according to claim 1, wherein the plurality of sensors are arranged throughout the mesh (40) such that the mesh (40) is a sensorized mesh.

3. The device according to claim 1, wherein the plurality of sensors are arranged on the anchoring portion (22, 32).

4. The apparatus according to any of the preceding claims, wherein at least one of the fixed portions (21, 31) further comprises a motion mechanism (50) configured to allow controlled reciprocating extension and retraction of the anchoring portions (22, 32).

5. The device according to claim 4, wherein the motion mechanism (50) includes a guide (51) and a sliding mechanism (52) configured to slide via the guide (51).

6. The apparatus according to any of the preceding claims, wherein the handle (10) includes a pivoting element (15) at the end connected to the support element (11).

7. The device according to any of the preceding claims, wherein the handle (10) further comprises a push button (9) configured to allow the handle (10) to rotate from an initial position to a final position along at least one axis, such that when the handle (10) is in the final position, the angle between the handle (10) and the first arm (20) and the second arm (30) can reach up to 180°.

8. The apparatus according to any of the preceding claims, wherein the support element (11) further comprises a toothed control wheel (13) for opening and closing the first arm (20) and the second arm (30).

9. The apparatus according to any of the preceding claims, wherein the support element (11) further comprises a push button (12) configured to abruptly close the first arm (20) and the second arm (30) using a braking mechanism (18) and a worm gear mechanism (17).

10. The device according to any of the preceding claims, wherein the mesh (40) comprises a biocompatible material or coating.

11. The device of claim 10, wherein the biocompatible material comprises at least one polymer.

12. The apparatus according to any one of the preceding claims, wherein the plurality of sensors are configured to transmit the detected pressure to a computer device.

13. The device according to any one of claims 1-9, wherein the plurality of sensors are configured to transmit the detected pressure to a communication module contained within the support element (11).

14. The apparatus according to any of the preceding claims, wherein the first arm (20) and the second arm (30) are made of stainless steel.

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