Adsorption ball and surgical instrument for minimally invasive encephaloma elimination

Abstract

The utility model discloses an adsorption ball and a surgical instrument for minimally invasive encephaloma elimination, and belongs to the technical field of neurosurgery auxiliary instruments, the adsorption ball comprises a main body, a cavity used for creating a water environment surgical space is arranged in the main body, a base used for being attached to a skull is arranged below the main body, and the main body is provided with a plurality of suction holes. An opening communicated with the cavity is formed in the middle of the base; two sides of the main body are respectively provided with a water injection channel and a water drainage channel which are communicated with the cavity, and the top of the main body is provided with an instrument channel and an endoscope channel which are communicated with the cavity. The device can achieve a minimally invasive surgery mode, is easy and convenient to operate, thorough in flushing and convenient to drain, reduces the probability of occurrence of intracranial pneumatosis and the like, and is small in trauma and high in safety.

Description

Technical Field

[0001] The utility model relates to the technical field of neurosurgery auxiliary instruments, in particular to an adsorption ball and a surgical instrument for minimally invasive cerebral hematoma elimination surgery. Background Art

[0002] Intracerebral hematoma is a hematoma formed by bleeding in the brain after a head injury. Most of the causes are due to damage to small blood vessels deep in the brain. Craniocerebral injury can easily cause epidural hematoma caused by brain trauma. In mild cases, patients will experience headaches or vomiting symptoms, and in severe cases, death may occur. It has the characteristics of high morbidity, high disability and high mortality, which seriously threatens the life and health of patients. Therefore, it is necessary to eliminate the hematoma. There are many treatments for intracerebral hematoma. Surgical treatment can be divided into: craniotomy with bone flap to remove hematoma, keyhole minimally invasive surgery to remove hematoma, puncture and drainage of hematoma, neuroendoscopic removal of hematoma, etc. Each method has its own characteristics and scope of application.

[0003] Craniotomy hematoma removal: Hematoma removal is more thorough, hemostasis is reliable, and brain tissue pressure can be quickly relieved. However, it requires general anesthesia, a long operation time, more bleeding, greater trauma, and severe edema reaction after brain tissue damage. Currently, it is mostly suitable for patients with subcortical hemorrhage in the cerebral hemisphere and superficial hemorrhage in the cerebral lobe; patients with hematoma volume greater than 30ml or obvious displacement of midline structure; patients with cerebellar hematoma greater than 10ml, and compression and deformation of the fourth ventricle or brainstem.

[0004] Hematoma puncture: less trauma, simple operation, low cost, high success rate. However, the hard part of the hematoma cannot be removed in the early stage, making some hematomas difficult to remove within 24 hours to 14 days after formation. Therefore, it is not suitable for patients with a tendency of brain herniation. If urokinase or various instruments such as ARCHIMEDES drill, ultrasonic aspiration, improved nerve knife, etc. are used at the same time during hematoma puncture, the hematoma can be better removed in a short period of time and better results can be achieved.

[0005] Ventricular puncture and drainage: It is suitable for various cerebral hemorrhages that break into the ventricles. At the same time, urokinase is used in combination with lumbar puncture to release cerebrospinal fluid to treat intraventricular hematoma, promote the discharge of blood and metabolites, and reduce mortality. Ventricular puncture in the acute stage can reduce intracranial pressure and reduce the damage of intraventricular hematoma to brain tissue.

[0006] Endoscopic treatment of intracerebral hemorrhage: It has not yet become mainstream in neurosurgical practice, but endoscopic hematoma removal can be performed under direct vision and can stop bleeding at the same time. It is superior to stereotactic catheter drainage under blind vision and has good prospects.

[0007] In summary, there is no perfect technology that takes into account the treatment effect, success rate and efficiency of intracerebral hematoma. However, the goals of this type of surgery can be determined: 1. The surgery causes little damage: minimally invasive and short time; 2. Convenient operation: large surgical field and convenient use of instruments, such as endoscopic surgery, electrodes, ultrasonic scalpels, bipolar forceps and other instruments; 3. Good surgical effect: thorough removal of hematoma, few sequelae, such as intracranial gas accumulation, cerebrospinal fluid leakage, and low incidence of infectious complications.

[0008] Traditional surgery has high intraoperative risks and increases the chance of postoperative infection. Due to concerns about surgical risks, finding a less traumatic and safer method for removing cerebral hematomas has always been a key research issue for neurosurgeons. Utility Model Content

[0009] The technical problem to be solved by the utility model is to provide an adsorption ball with little trauma and high safety and a surgical instrument for minimally invasive cerebral hematoma elimination surgery.

[0010] In order to solve the above technical problems, the utility model provides the following technical solutions:

[0011] On the one hand, the utility model provides an adsorption ball, comprising a main body, wherein a cavity for creating a water environment surgical space is provided in the main body, wherein:

[0012] A base for fitting with the skull is provided below the main body, and an opening communicating with the cavity is provided in the middle of the base;

[0013] A water injection channel and a drainage channel connected to the cavity are respectively arranged on both sides of the main body, and an instrument channel and an endoscope channel connected to the cavity are arranged on the top of the main body.

[0014] Furthermore, the main body is a deformable main body with a certain deformation amount;

[0015] And / or, the main body is made of plastic material;

[0016] And / or, the hardness of the main body is 50 degrees to 70 degrees.

[0017] Furthermore, the main body includes a frustoconical lower body and a hemispherical upper body covering the lower body.

[0018] Furthermore, the base is provided with bone screw holes;

[0019] And / or, the lower surface of the base is a curved surface.

[0020] Furthermore, both the instrument channel and the endoscope channel are provided with a one-way valve for sealing the cavity and allowing the instrument to pass through.

[0021] On the other hand, the utility model provides a surgical instrument for minimally invasive cerebral hematoma elimination surgery, comprising a plasma surgical electrode and the above-mentioned adsorption ball.

[0022] Furthermore, the plasma surgical electrode comprises a cable, a first handle and an electrode rod connected in sequence, an excitation electrode and a loop electrode are provided at the distal end of the electrode rod, and the plasma surgical electrode uses the physiological saline injected into the cavity as a conductive liquid to generate plasma.

[0023] Furthermore, an insulating layer is provided between the excitation electrode and the loop electrode;

[0024] And / or, the electrode rod is coated with an insulating layer;

[0025] and / or, the radio frequency voltage applied to the plasma surgical electrode is 100V-300V;

[0026] And / or, the distance between the excitation electrode and the loop electrode is 1 mm-3 mm;

[0027] And / or, the front end of the electrode rod of the plasma surgical electrode is needle-shaped or column-shaped, and the overall diameter is 1mm-3mm.

[0028] Furthermore, the surgical instrument for minimally invasive cerebral hematoma elimination surgery also includes a hemostatic stripping forceps, which includes a rod body, a second handle is provided at the rear end of the rod body, a jaw is provided at the front end of the rod body, a water outlet is provided in the middle of the rod body, a crank slider is used to drive the jaw, and a standard interface is provided at the tail of the second handle or it is an integrated structure connected to a cable.

[0029] Furthermore, the surgical instrument for minimally invasive cerebral hematoma removal surgery also includes an ultrasonic bone knife, which uses piezoelectric materials to convert electrical energy into high-frequency micro-vibration of the blade to perform bone cutting.

[0030] The utility model has the following beneficial effects:

[0031] The adsorption ball and the surgical instrument for minimally invasive cerebral hematoma elimination of the utility model can realize minimally invasive surgery, are easy to operate, thoroughly flush, facilitate drainage, reduce the probability of intracranial gas accumulation, etc., have little trauma and high safety. BRIEF DESCRIPTION OF THE DRAWINGS

[0032] Figure 1 It is a schematic diagram of the three-dimensional structure of the adsorption ball of the utility model;

[0033] Figure 2 Schematic diagram of the cross-sectional structure of the adsorption ball of the utility model, wherein (a) is a cross-sectional structure diagram in one direction, and (b) is a cross-sectional structure diagram in another direction;

[0034] Figure 3 This is a schematic diagram of the use state of the adsorption ball of the utility model;

[0035] Figure 4 for Figure 3 Schematic diagram of the structure of the medium plasma surgical electrode;

[0036] Figure 5 for Figure 4 Schematic diagram of the structure of the middle electrode rod;

[0037] Figure 6 for Figure 3 Schematic diagram of the structure of the hemostatic stripping forceps. DETAILED DESCRIPTION

[0038] In order to make the technical problems to be solved, technical solutions and advantages of the present invention more clear, a detailed description will be given below in conjunction with the accompanying drawings and specific embodiments.

[0039] In the description of the present invention, it should be understood that the terms "upper", "lower", "front", "back", "left", "right", etc. indicate directions or positional relationships based on the directions or positional relationships shown in the accompanying drawings, and are only for the convenience of describing the present invention and simplifying the description, rather than indicating or implying that the device or element referred to must have a specific direction, be constructed and operated in a specific direction, and therefore should not be understood as a limitation on the present invention.

[0040] On the one hand, the utility model provides an adsorption ball 1, which is used as a water environment container, such as Figure 1-3 As shown, it includes a main body 11, and a cavity 10 is provided in the main body 11 for creating a water environment surgical space (i.e. a closed water storage space), wherein:

[0041] A base 12 for fitting with the skull 5 is provided below the main body 11, and a (surgical) opening 17 communicating with the cavity 10 is provided in the middle of the base 12;

[0042] A water injection channel 13 (for injecting saline solution to create a water environment, or injecting drugs at the same time) and a drainage channel 14 (for draining waste liquid) connected to the cavity 10 are respectively provided on both sides of the main body 11. An instrument channel 15 and an endoscope channel 16 connected to the cavity 10 are provided on the top of the main body 11. The endoscope channel 16 and the instrument channel 15 serve as connecting puncture channels for the neuroendoscope 4 and other instruments to pass through.

[0043] When using the adsorption ball 1 of the utility model for surgery, Figure 3 The surgical steps can be referred to as follows:

[0044] 1. Make a clear diagnosis through cranial CT and MRI, determine the location and blood volume of the hematoma, and clarify the surgical indications;

[0045] 2. Positioning based on imaging examination;

[0046] 3. Use passive instruments to cut the scalp and hook-shaped instruments to stretch the scalp;

[0047] 4. Fix the adsorption ball 1 on the human skull through the base 12, connect the water injection channel 13 to the saline bag, close the drainage channel 14, and build a "water environment" surgical space, that is, create a water environment surgical space in the cavity 10;

[0048] 5. Insert the neuroendoscope 4 into the "water environment" space through the endoscope channel 16 for visual guidance;

[0049] 6. The ultrasonic osteotome 6 punches a hole in the skull 5 through the instrument channel 15;

[0050] 7. Plasma surgical electrode 2 cuts the subcranial dura mater;

[0051] 8. Use hemostatic stripping forceps 3 to stop bleeding at the subdural bleeding point;

[0052] 9. Place a 12# suction tube (a standard medical device used to draw hematomas) into the skull to guide the hematoma;

[0053] 10. Remove the adsorption ball 1 and other devices, seal the wound, and keep it in the human skull 5 for about one week. Figure 3 The number 7 is the water injection pipeline, and the number 8 is the drainage pipeline.

[0054] The adsorption ball of the utility model is suitable for cerebral hematoma suction drainage, and the benefits brought are as follows:

[0055] 1. The adsorption ball provides a channel for plasma surgical electrodes, ultrasonic bone knives, etc., which facilitates the accurate positioning of the instruments and reduces the damage caused by the shaking of the instruments;

[0056] 2. Minimally invasive surgery requires only a small incision of 10mm to 15mm on the head;

[0057] 3. The adsorption ball can create a water environment to prevent air from contacting the intracranial wound and reduce the occurrence of complications such as intracranial bloating;

[0058] 4. The presence of water pressure reduces bleeding;

[0059] 5. The adsorption ball provides a channel for the neuroendoscope, which expands the surgical field and makes the surgical operation more convenient;

[0060] 6. The operation is convenient and efficient, which shortens the operation time.

[0061] The above-mentioned minimally invasive surgical method is easy to operate, thoroughly flushes, facilitates drainage, reduces the probability of intracranial gas accumulation, etc., is less traumatic and highly safe.

[0062] The main body 11 can be a deformable main body with a certain deformation amount, which can expand after injecting physiological saline and shrink after draining. The main body 11 can be made of plastic material, such as medical silica gel, TPU (thermoplastic polyurethane), etc., and the hardness can be 50 degrees to 70 degrees.

[0063] The main body 11 can be of various shapes. To facilitate surgical operations, preferably, the main body 11 includes a conical lower body 11a and a hemispherical upper body 11b covering the lower body 11a. In this case, the water injection channel 13, the instrument channel 15 and the endoscope channel 16 can all be located on the upper body 11b, and the drainage channel 14 can be located on the lower body 11a.

[0064] In order to facilitate the fixation of the adsorption ball 1 on the human skull, various methods can be used, such as gluing, suction cup adsorption, strap fixation, etc. However, in order to improve the firmness, a bone screw hole 121 can be provided on the base 12, and the adsorption ball 1 can be fixed on the human skull by a self-tapping screw. In specific implementation, the bone screw holes 121 can be 3-6, with a diameter of 1.5mm-2mm, and can be installed in conjunction with M1.5 self-tapping bone screws. The lower surface of the base 12 can be a curved surface, and the curved surface is used to achieve fit with the skull 5, which can prevent the risk of leakage, gas ingress, etc.

[0065] The instrument channel 15 and the endoscope channel 16 can fit closely with the outer diameter of the corresponding instrument to prevent leakage. However, to facilitate the manipulation of the instrument, both the instrument channel 15 and the endoscope channel 16 are preferably provided with a one-way valve for sealing the cavity 10 and allowing the instrument to pass through.

[0066] On the other hand, the utility model provides a surgical instrument for minimally invasive cerebral hematoma elimination surgery, such as Figure 3 As shown, it includes a plasma surgical electrode 2 and the above-mentioned adsorption ball 1. The structure of the adsorption ball 1 is the same as above, so it will not be repeated here.

[0067] The utility model provides a surgical instrument for minimally invasive cerebral hematoma elimination surgery, which can realize minimally invasive surgery, is easy to operate, thoroughly flushes, facilitates drainage, reduces the probability of intracranial gas accumulation, etc., has low trauma and high safety.

[0068] like Figure 4-5As shown, the plasma surgical electrode 2 may include a cable 21, a first handle 22 and an electrode rod 23 connected in sequence, and an excitation electrode 231 and a return electrode 232 are provided at the distal end of the electrode rod 23. The plasma surgical electrode 2 uses the physiological saline injected into the cavity as a conductive liquid to generate plasma. In this way, the excitation electrode 231 and the return electrode 232 are placed at the distal end of the electrode rod 23 close to the target tissue, and the host applies radio frequency energy to achieve cutting, ablation, heating and coagulation of the tissue.

[0069] The configuration of the plasma surgical electrode 2 is usually a circular electrode rod with a bipolar structure. The excitation electrode 231 is at the front end of the electrode rod 23, and the outer stainless steel tube is used as the return electrode 232. To improve safety, an insulating layer 233 may be provided between the excitation electrode 231 and the return electrode 232. The electrode rod 23 may be coated with an insulating layer 234. Depending on the surgical site, the radio frequency voltage applied to the plasma surgical electrode 2 may be 100V-300V. The spacing between the excitation electrode 231 and the return electrode 232 may be 1mm-3mm, so an electric field of 3000V / CM will be generated between the excitation electrode and the return electrode. During the operation, there is tissue and conductive fluid on the outside of the electrode rod 23, and the current returns from the excitation electrode 231 through the conductive fluid and tissue to the return electrode 232. The electrode rod 23 of the plasma surgical electrode 2 can be designed to be straight or angled, which can be changed according to the operating space and the surgical field of view. The front end of the electrode rod 23 of the plasma surgical electrode 2 can be needle-shaped or cylindrical, with an overall diameter of 1mm-3mm.

[0070] like Figure 6 As shown, the surgical instrument for minimally invasive cerebral hematoma removal surgery can also include a hemostatic stripping forceps 3 (with hemostasis and stripping functions). The hemostatic stripping forceps 3 can include a rod body 31, a second handle 32 is provided at the rear end of the rod body 31, a jaw 33 is provided at the front end of the rod body 31, and a water outlet 34 is provided in the middle of the rod body 31. The second handle 32 adopts a crank slider to drive the jaw 33, which has a simple structure and is easy to operate; the tail of the second handle 32 is provided with a standard interface 35 or is an integrated structure connected to a cable.

[0071] In specific implementation, the interior of the hemostatic stripping forceps 3 can be provided with an insulating layer, the front jaw 33 can be coated with a special coating process to prevent adhesion of tissues affecting the surgical effect, a water outlet 34 is provided in the middle, and the interface can be a spiral Luer connector, which has strong adaptability to standard interfaces. The second handle 32 can be provided with a silicone anti-slip material.

[0072] The skull is adjacent to important blood vessels and nerves. During the exposure and removal of hematoma, sufficient and precise skull base bone resection is often required to increase the surgical field of view and operating space, protect brain tissue and important blood vessels and nerves, and reduce the risk of postoperative neurological dysfunction. The traditional method is to use milling cutters and grinding drills to process bones, but when performing deep skull base bone grinding adjacent to important nerves and blood vessels such as the petrous apex, the medial part of the sphenoid ridge, the anterior clinoid process, and the internal auditory canal, the narrow operating space will limit the surgeon's operation, and the high-speed axial force and heat generated by the grinding drill will easily damage the neurovascular structure, which may even lead to catastrophic consequences.

[0073] To solve this problem, the surgical instrument for minimally invasive cerebral hematoma removal surgery can also include an ultrasonic bone knife 6. The ultrasonic bone knife 6 is based on the piezoelectric effect in physics, and uses piezoelectric materials to convert electrical energy into high-frequency micro-vibration of the knife head for bone cutting. Different from the high-speed axial operation mode of the grinding drill, the ultrasonic bone knife 6 applies force in a linear direction when cutting bones, which can achieve in-situ precise cutting of bone tissue and effectively avoid iatrogenic damage to surrounding soft tissues and cotton scraping. This feature is particularly important for improving the safety of deep skull base bone grinding.

[0074] The above is a preferred embodiment of the present invention. It should be pointed out that, for ordinary technicians in this technical field, several improvements and modifications can be made without departing from the principles of the present invention. These improvements and modifications should also be regarded as the protection scope of the present invention.

Claims

1. An adsorption ball, characterized in that: The device comprises a main body, wherein a cavity for creating a water environment surgical space is provided in the main body, wherein: A base for fitting with the skull is provided below the main body, and an opening communicating with the cavity is provided in the middle of the base; A water injection channel and a drainage channel connected to the cavity are respectively arranged on both sides of the main body, and an instrument channel and an endoscope channel connected to the cavity are arranged on the top of the main body.

2. The adsorption ball according to claim 1, characterized in that: The main body is a deformable main body with a certain deformation amount; And / or, the main body is made of plastic material; And / or, the hardness of the main body is 50 degrees to 70 degrees.

3. The adsorption ball according to claim 1, characterized in that: The main body comprises a frustoconical lower body and a hemispherical upper body which is covered on the lower body.

4. The adsorption ball according to claim 1, characterized in that: The base is provided with bone screw holes; And / or, the lower surface of the base is a curved surface.

5. The adsorption ball according to claim 1, characterized in that: Both the instrument channel and the endoscope channel are provided with one-way valves for sealing the cavity and allowing instruments to pass through.

6. A surgical instrument for minimally invasive cerebral hematoma removal, characterized in that: The invention comprises a plasma surgical electrode and the adsorption ball as described in any one of claims 1 to 5.

7. The surgical instrument for minimally invasive cerebral hematoma elimination according to claim 6, characterized in that: The plasma surgical electrode comprises a cable, a first handle and an electrode rod which are connected in sequence. The distal end of the electrode rod is provided with an excitation electrode and a loop electrode. The plasma surgical electrode uses physiological saline injected into the cavity as a conductive liquid to generate plasma.

8. The surgical instrument for minimally invasive cerebral hematoma elimination according to claim 7, characterized in that: An insulating layer is provided between the excitation electrode and the loop electrode; And / or, the electrode rod is coated with an insulating layer; and / or, the radio frequency voltage applied to the plasma surgical electrode is 100V-300V; And / or, the distance between the excitation electrode and the loop electrode is 1 mm-3 mm; And / or, the front end of the electrode rod of the plasma surgical electrode is needle-shaped or column-shaped, and the overall diameter is 1mm-3mm.

9. The surgical instrument for minimally invasive cerebral hematoma elimination according to claim 6, characterized in that: The surgical instrument for minimally invasive cerebral hematoma elimination surgery also includes a hemostatic stripping forceps, which includes a rod body, a second handle is provided at the rear end of the rod body, a jaw is provided at the front end of the rod body, a water outlet is provided in the middle of the rod body, a crank slider is used to drive the jaw, and a standard interface is provided at the tail of the second handle or it is an integrated structure connected to a cable.

10. The surgical instrument for minimally invasive cerebral hematoma elimination according to claim 6, characterized in that: The surgical instrument for minimally invasive cerebral hematoma elimination surgery also includes an ultrasonic bone knife, which uses piezoelectric materials to convert electrical energy into high-frequency micro-vibration of the knife head to perform bone cutting.

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