Dura mater suturing device under nasal endoscope

Abstract

The utility model provides a dura mater suturing device under a nasal endoscope, which comprises a titanium clip, and matched sawteeth are respectively arranged on the inner walls of two sides of the titanium clip; the clamp holder comprises a fixed rod, a movable rod arranged at the upper end of the fixed rod in a sliding mode, a lower clamp head, a fixed handle, an upper clamp head rotationally connected with the front end of the fixed rod through a first rotating shaft and a movable handle rotationally connected with the fixed handle through a second rotating shaft, wherein the lower clamp head and the fixed handle are fixedly connected to the two ends of the fixed rod respectively. A first linkage assembly is arranged between the movable handle and the movable rod, and when the movable handle rotates relative to the fixed handle, the movable rod is driven to slide along the fixed rod; and a second linkage assembly is arranged between the upper tong head and the end part of the movable rod. The operation defect that multiple times of suturing and knotting are needed in a narrow and deep space is overcome, the skull base dura mater can be sutured rapidly and firmly, the endoscopic skull base dura mater suturing technology is greatly simplified, the operation time is shortened, the suturing effect is improved, and the incidence rate of the complication of leakage of cerebrospinal fluid after a transnasal endoscopic skull base operation can be effectively reduced.

Description

Technical Field

[0001] The utility model belongs to the technical field of medical surgical instruments, and in particular relates to a dura mater suturing device under nasal endoscopy. Background Art

[0002] Endoscopic skull base surgery is not only used for optic nerve decompression and cerebrospinal fluid rhinorrhoea repair, but also extends to the removal of sellar craniopharyngioma, meningioma, intracranial cysts and sellar malignant tumors. With the application of rigid endoscopes of various angles and the advancement of endoscopic skull base surgery technology, its advantages of good visual field, clear identification of deep anatomical structures, wide range of lesions, minimally invasive, few complications and low mortality rate have not only overcome the shortcomings of the above-mentioned traditional surgical approaches, but also gradually demonstrated the ability and superiority of endoscopic transnasal approach to treat complex skull base lesions.

[0003] Although endoscopic skull base surgery plays an important role in the treatment of skull base diseases, postoperative cerebrospinal fluid leakage has limited the further development of this technology. The pedicled nasal septum mucosal flap can effectively improve the success rate of postoperative cerebrospinal fluid leakage repair, but this method is difficult to provide effective support for some large skull base dura mater defects and high-flow cerebrospinal fluid leakage. The pulsation of cerebrospinal fluid can easily cause leakage at the defect, leading to repair failure. In addition, the use of pedicled nasal septum mucosal flaps can also cause problems such as nasal dryness and increased rate of olfactory loss. Endoscopic dura mater suture technology has achieved very good treatment results in high-flow postoperative cerebrospinal fluid leakage, and can also shorten bed rest time, reduce bed rest complications, and enable patients to recover quickly. The difficulty of endoscopic skull base suturing lies in the following aspects: (1) the nasal cavity operation area is deep, the space is narrow, and the freedom of movement of the instrument is limited; (2) there are structures such as the optic nerve, internal carotid artery, cavernous sinus and its accessory veins around it, which need to be avoided during suturing; (3) the two-dimensional field of view of the endoscope lacks a sense of three-dimensionality, the depth is difficult to confirm, the insertion and movement of the needle lack a three-dimensional sense, and the instrument is slender, the sense of touch is weakened, and accuracy must be grasped; (4) deep knotting is difficult; (5) the original dura mater is affected and becomes weak or incomplete, the suturing effect is poor, and it is difficult to achieve an ideal watertight suturing. Suturing some areas is difficult or even impossible. In addition, the endoscopic skull base suturing operation time is long (for cases of Esposito grade 3 leakage, the skull base reconstruction time is as long as 90 minutes), so the endoscopic dura mater suturing technology is not widely used.

[0004] In summary, there is an urgent need to design a transnasal endoscopic dura mater suturing device that overcomes the above-mentioned problems. Utility Model Content

[0005] The utility model aims to provide a dura mater suturing device under nasal endoscopy which can overcome the above problems.

[0006] In order to achieve the above-mentioned purpose, the technical solution adopted by the utility model is: a dura mater suturing device under nasal endoscopy, comprising:

[0007] The titanium clip has matching serrations on the inner walls of both sides;

[0008] The clamp comprises a fixed rod, a movable rod slidably arranged on the upper end of the fixed rod,

[0009] A lower clamp head and a fixed handle respectively fixedly connected to both ends of the fixed rod, an upper clamp head rotatably connected to the front end of the fixed rod via a first rotating shaft, and a movable handle rotatably connected to the fixed handle via a second rotating shaft;

[0010] Wherein, a first linkage assembly is further provided between the movable handle and the movable rod, and when the movable handle rotates relative to the fixed handle, the movable rod is driven to slide relatively along the fixed rod;

[0011] A second linkage assembly is also provided between the upper clamp head and the end of the movable rod. When the movable rod slides relatively along the fixed rod, the upper clamp head is driven to open or close.

[0012] The purpose of the utility model and the solution to its technical problems can also be further achieved by adopting the following technical measures.

[0013] Furthermore, the first linkage assembly includes a limit bar fixedly connected to the upper end of the movable handle, a first guide slot hole provided on the limit bar and along the length direction thereof, and a first pin fixed to the side wall of the movable rod;

[0014] The first pin is fixed on the side wall of the movable groove opened at the lower end of the movable rod, and the first pin is movably inserted into the first guide slot hole.

[0015] Furthermore, the second linkage assembly includes a second guide slot hole provided on the upper clamp head close to one end of the movable rod and a second pin shaft fixed to the end of the movable rod and movably inserted into the second guide slot hole;

[0016] A slot is formed at the end of the movable rod, and the second pin is fixedly connected to the inner side wall of the slot.

[0017] Furthermore, a groove is provided on the upper surface of one end of the fixing rod close to the lower clamp head, and a latch is integrally connected to the bottom of the upper clamp head, and the latch is rotatably connected to the groove via the first rotating shaft.

[0018] Furthermore, a T-shaped sliding groove is provided on the side wall of the movable rod relative to the fixed rod, and a T-shaped sliding block matching the T-shaped sliding groove is provided on the upper end of the fixed rod.

[0019] Furthermore, the opposite side walls of the upper clamp head and the lower clamp head are respectively provided with accommodating grooves.

[0020] Furthermore, a return spring is provided between the movable handle and the fixed handle.

[0021] Furthermore, an arc-shaped rack is provided at one end of the movable handle close to the fixed handle, a tooth block meshing with the arc-shaped rack is provided on the fixed handle, one end of the tooth block is hinged to the fixed handle, and a torsion spring is provided between the tooth block and the fixed handle.

[0022] Furthermore, finger rings are respectively provided at the lower ends of the movable handle and the fixed handle.

[0023] Compared with the prior art, the beneficial effects of the utility model are:

[0024] The utility model discloses a transnasal endoscopic dura mater suturing device, which uses a clamp to insert a titanium clip into the human body for suturing surgery under the endoscope. Compared with the traditional surgical operation using ordinary instruments and sutures for suturing, it avoids the operational disadvantages of multiple suturing and knotting in a narrow and deep space, and can quickly and firmly suture the dura mater of the skull base. The utility model greatly simplifies the endoscopic skull base dura mater suturing technology, shortens the operation time, improves the suturing effect, and can effectively reduce the incidence of cerebrospinal fluid leakage, a complication after transnasal endoscopic skull base surgery, which is conducive to the widespread development of endoscopic skull base surgery. BRIEF DESCRIPTION OF THE DRAWINGS

[0025] Figure 1 It is a schematic diagram of the overall structure of the dura mater suturing device provided by the utility model under transnasal endoscopy;

[0026] Figure 2 It is a schematic diagram of the overall structure of the lower clamp head, the fixing rod and the fixing handle in the embodiment of the utility model;

[0027] Figure 3 It is a schematic diagram of the overall structure of the upper clamp head, the movable rod and the movable handle in the embodiment of the utility model;

[0028] Figure 4 It is an enlarged schematic diagram of the first connecting component in the embodiment of the utility model;

[0029] Figure 5 is a cross-sectional schematic diagram of the second connecting component in an embodiment of the utility model;

[0030] Figure 6 The overall structure of the titanium clip in the embodiment of the utility model is shown in FIG. Figure 1 (Titanium clip open state);

[0031] Figure 7The overall structure of the titanium clip in the embodiment of the utility model is shown in FIG. Figure 1 (Titanium clip closed state);

[0032] Description of reference numerals:

[0033] 1. Titanium clip; 11. Sawtooth;

[0034] 2. Clamp; 21. Fixed rod; 211. Groove; 22. Movable rod; 221. Movable groove; 222. Clamping groove; 223. T-shaped slide groove; 224. T-shaped slide block; 23. Lower clamp head; 24. Fixed handle; 25. First rotating shaft; 26. Upper clamp head; 261. Clamping tongue; 262. Accommodating groove; 27. Second rotating shaft; 28. Movable handle; 281. Finger ring;

[0035] 3. First linkage assembly; 31. Limiting strip; 32. First guide slot; 33. First pin shaft;

[0036] 4. second linkage assembly; 41. second guide slot; 42. second pin shaft;

[0037] 5. Return spring;

[0038] 6. Arc-shaped rack; 61. Tooth block; 62. Torsion spring. DETAILED DESCRIPTION

[0039] In order to make the purpose, technical solution and advantages of the utility model more clear, the utility model is further described in detail below in conjunction with the accompanying drawings and embodiments. It should be understood that the specific embodiments described here are only used to explain the utility model and are not used to limit the utility model.

[0040] See also Figures 1 to 7 , a transnasal endoscopic dura mater suturing device, comprising:

[0041] The titanium clip 1 has matching serrations 11 on both inner walls; the titanium clip is "U"-shaped, and the serrations 11 on the inner side can be staggered and matched when closed to prevent falling off and moving. The length of the titanium clip 1 is 3mm, which is suitable for intraoperative operation habits. The edge of the cut dura mater is about 2mm away from the bone window; the diameter of the clip 1 is 0.75mm and 0.5mm, which can be selected according to the surgical requirements.

[0042] The clamp 2 comprises a fixed rod 21, a movable rod 22 slidably arranged at the upper end of the fixed rod 21, a lower clamp head 23 and a fixed handle 24 respectively fixedly connected to both ends of the fixed rod 21, an upper clamp head 26 rotatably connected to the front end of the fixed rod 21 via a first rotating shaft 25, and a movable handle 28 rotatably connected to the fixed handle 24 via a second rotating shaft 27;

[0043] A first linkage assembly 3 is further provided between the movable handle 28 and the movable rod 22. When the movable handle 28 rotates relative to the fixed handle 24, the movable rod 22 is driven to slide relatively along the fixed rod 21.

[0044] A second linkage assembly 4 is further provided between the upper clamp head 26 and the end of the movable rod 22 . When the movable rod 22 slides relatively along the fixed rod 21 , the upper clamp head 26 is driven to open or close.

[0045] The length of the clamp holder 2 is 15-17 cm, and different lengths can be selected as needed. The diameter of the clamp holder 2 is about 3 mm, which is conducive to operating in a narrow space of the nasal cavity (single nostril or double nostrils). The width of the clamp tip of the clamp holder 1 is 1.5 mm to adapt to the narrow operating space.

[0046] Preferably, the first linkage assembly 3 includes a limit bar 31 fixedly connected to the upper end of the movable handle 28, a first guide slot 32 opened on the limit bar 31 and arranged along the length direction thereof, and a first pin 33 fixed to the side wall of the movable rod 22;

[0047] The first pin shaft 33 is fixed on the side wall of the movable slot 221 provided at the lower end of the movable rod 22, and the first pin shaft 33 is movably arranged in the first guide slot hole 32. When the movable handle 28 rotates relative to the fixed handle 24, the limit bar 31 can be driven to rotate along the second rotating shaft 27, and the first pin shaft 33 can slide back and forth in the first guide slot hole 32, so that the movable rod 22 can slide back and forth along the fixed rod 21.

[0048] Preferably, the second linkage assembly 4 includes a second guide slot 41 provided at one end of the upper clamp head 26 close to the movable rod 22 and a second pin 42 fixed to the end of the movable rod 22 and movably inserted into the second guide slot 41;

[0049] The end of the movable rod 22 is provided with a slot 222, and the second pin 42 is fixedly connected to the inner wall of the slot 222. When the movable rod 22 slides relative to the fixed rod 21, the upper clamp head 26 can be driven to rotate along the first rotating shaft 25, and the second pin 42 is driven by the movable rod 22 to slide back and forth in the second guide slot 41, so that the upper clamp head 26 is opened or closed.

[0050] Preferably, a groove 211 is formed on the upper surface of one end of the fixing rod 21 close to the lower clamp head 23, and a latch 261 is integrally connected to the bottom of the upper clamp head 26, and the latch 261 is rotatably connected to the groove 211 through the first rotating shaft 25. The latch 261 is at a certain angle to the upper clamp head 26, so that the upper clamp head 26 can be rotated to be flush with the lower clamp head 23.

[0051] Preferably, a T-shaped slot 223 is formed on a side wall of the movable rod 22 opposite to the fixed rod 21 , and a T-shaped sliding block 224 matching the T-shaped slot 223 is formed on an upper end of the fixed rod 21 .

[0052] Preferably, the opposite side walls of the upper clamp head 26 and the lower clamp head 23 are respectively provided with a receiving groove 262, so that the titanium clip 1 can be firmly placed in the receiving groove 262 between the upper and lower clamp heads to avoid slipping.

[0053] Preferably, a return spring 5 is further provided between the movable handle 28 and the fixed handle 24 .

[0054] Preferably, the movable handle 28 is also provided with an arc-shaped rack 6 at one end close to the fixed handle 24, and the fixed handle 24 is provided with a tooth block 61 meshing with the arc-shaped rack 6, one end of the tooth block 61 is hinged to the fixed handle 24, and a torsion spring 62 is also provided between the tooth block 61 and the fixed handle 24. The clamp holder 2 is provided with a return spring 5 and an arc-shaped rack 6 and a tooth block 61 meshing therewith, which can ensure that the titanium clamp 1 is firmly fixed in the receiving groove 262 between the upper and lower pliers heads. When in use, the doctor's finger presses down the tooth block 61 to disengage the tooth block 61 from the arc-shaped rack 6. When the tooth block 61 is not pressed, it is always meshed and connected with the arc-shaped rack 6 under the action of the torsion spring 62, ensuring that the pliers head clamps the titanium clamp; preferably, the lower ends of the movable handle 28 and the fixed handle 24 are also provided with finger rings 281 respectively.

[0055] Since the titanium clip 1 is fixed on the dura mater, it will fuse with the dura mater over time, and the possibility of falling off is almost zero; and existing research reports have shown that the titanium clip 1 has very small artifacts during MRI examinations and does not affect postoperative MRI examinations.

[0056] The present invention is further described above in conjunction with the embodiments, but the present invention is not limited to the above embodiments, and various changes can be made within the knowledge scope of ordinary technicians in this field without departing from the purpose of the present invention.

Claims

1. A transnasal endoscopic dura mater suturing device, characterized in that: It includes: The titanium clip (1) has inner walls on both sides provided with matching saw teeth (11); The clamp (2) comprises a fixed rod (21), a movable rod (22) slidably arranged on the upper end of the fixed rod (21), a lower clamp head (23) and a fixed handle (24) respectively fixedly connected to both ends of the fixed rod (21), an upper clamp head (26) rotatably connected to the front end of the fixed rod (21) via a first rotating shaft (25), and a movable handle (28) rotatably connected to the fixed handle (24) via a second rotating shaft (27); A first linkage assembly (3) is further provided between the movable handle (28) and the movable rod (22), and when the movable handle (28) rotates relative to the fixed handle (24), the movable rod (22) is driven to slide relatively along the fixed rod (21); A second linkage assembly (4) is also provided between the upper clamp head (26) and the end of the movable rod (22). When the movable rod (22) slides relatively along the fixed rod (21), the upper clamp head (26) is driven to open or close.

2. The endoscopic dura mater suturing device according to claim 1, characterized in that: The first linkage assembly (3) comprises a limit bar (31) fixedly connected to the upper end of the movable handle (28), a first guide slot (32) provided on the limit bar (31) and along its length direction, and a first pin (33) fixed to the side wall of the movable rod (22); The first pin shaft (33) is fixed on the side wall of the movable groove (221) opened at the lower end of the movable rod (22), and the first pin shaft (33) is movably inserted into the first guide slot hole (32).

3. The endoscopic dura mater suturing device according to claim 1 or 2, characterized in that: The second linkage assembly (4) comprises a second guide slot (41) provided on the upper clamp head (26) near one end of the movable rod (22) and a second pin (42) fixed to the end of the movable rod (22) and movably inserted into the second guide slot (41); A clamping groove (222) is provided at the end of the movable rod (22), and the second pin shaft (42) is fixedly connected to the inner side wall of the clamping groove (222).

4. The endoscopic dura mater suturing device according to claim 3, characterized in that: A groove (211) is provided on the upper surface of one end of the fixing rod (21) close to the lower clamp head (23); a latch tongue (261) is integrally connected to the bottom of the upper clamp head (26); and the latch tongue (261) is rotatably connected to the groove (211) via the first rotating shaft (25).

5. The endoscopic dura mater suturing device according to claim 1, characterized in that: The movable rod (22) is provided with a T-shaped sliding groove (223) on the side wall relative to the fixed rod (21), and the upper end of the fixed rod (21) is provided with a T-shaped sliding block (224) matching the T-shaped sliding groove (223).

6. The endoscopic dura mater suturing device according to claim 1, characterized in that: The opposite side walls of the upper clamp head (26) and the lower clamp head (23) are also respectively provided with accommodation grooves (262).

7. The endoscopic dura mater suturing device according to claim 1, characterized in that: A return spring (5) is also provided between the movable handle (28) and the fixed handle (24).

8. The endoscopic dura mater suturing device according to claim 1, characterized in that: An arc-shaped rack (6) is also provided at one end of the movable handle (28) close to the fixed handle (24); a tooth block (61) meshing with the arc-shaped rack (6) is provided on the fixed handle (24); one end of the tooth block (61) is hinged to the fixed handle (24); and a torsion spring (62) is also provided between the tooth block (61) and the fixed handle (24).

9. The endoscopic dura mater suturing device according to claim 1, characterized in that: Finger rings (281) are also provided at the lower ends of the movable handle (28) and the fixed handle (24), respectively.

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