Medical screw structure for corrective surgery for pectus excavatum deformity, surgical assistance device set using same, and surgical method using same

Abstract

The present invention relates to: a medical screw structure for corrective surgery for pectus excavatum deformity, wherein the medical screw structure provides assistance to prevent damage to the heart, which is the central organ of the circulatory system, or the lungs, which are respiratory organs, prior to surgery in which a correction rod for correcting pectus excavatum deformity is inserted between the lungs or heart and the sternum, which compresses the lungs or heart, in a patient having a pectus excavatum deformity; a surgical assistance device set using same; and a surgical method using same. The specific configuration of the medical screw structure includes: a head part (32) in which an annular ring portion (32a) is formed by bending an upper section having a preset thickness and length; a neck part (34) which is connected to the lower end of the head part (32) and extends vertically downward a preset length from the center of the ring portion (32a); and a body part (36) that extends continuously from the lower end of the neck part (34) and, toward the bottom, is curved more in a spiral shape having a preset pitch along the vertical length direction and the circumferential direction for a preset diameter.

Description

Medical screw structure for corrective surgery for pectus excavatum deformity, surgical auxiliary device set using the same, and surgical method using the same

[0001] The present invention relates to a medical screw structure for corrective surgery for pectus excavatum deformity, a surgical assist device set using the same, and a surgical method using the same, and more particularly, to a medical screw structure for corrective surgery for pectus excavatum deformity, a surgical assist device set using the same, and a surgical method using the same, for assisting in preventing damage to the heart or lungs prior to a surgery for inserting a correction rod between the lungs, which are respiratory organs, or the heart, which is a central organ of the circulatory system, and the sternum of a patient with pectus excavatum deformity that compresses them.

[0002] Generally, the deformities of the chest wall that make up the chest are broadly classified into sunken chest, also called concave chest, and protruding chest, also called convex chest.

[0003] The structure of the sternum, as shown in Fig. 1, is formed by interconnecting the ribs (10), sternum (12), costal cartilage (14), and spine (16).

[0004] In the structure of the sternum, concave chest and convex chest are not due to a deformity of the ribs (10), but rather to an abnormality of the costal cartilage (14) connecting the sternum (12) and the ribs (10) located in the center of the front of the chest.

[0005] It is reported that these symptoms are not severe at birth, but gradually worsen as the child grows.

[0006] In particular, in the case of pectus excavatum, the sunken chest wall compresses the heart or lungs, causing functional disorders in the relevant areas.

[0007] Treatments for this type of pectus excavatum are known by the names Ravitch procedure and Nuss procedure.

[0008] The former Ravitch method is performed by opening the chest widely and removing all costal cartilage. However, after the surgery, the chest wall becomes weak or adhesions form, which not only causes loss of smooth movement of the chest, but also leaves a large scar on the chest.

[0009] The latter, the Nuss procedure, was invented by Donald Nuss of the United States in 1997 and is a surgical procedure to correct pectus excavatum as an alternative to the Ravitch procedure.

[0010] In addition, in the Nurse surgical method, for a patient with a sunken chest wall area indicated by hatching (H) in Fig. 2(a), an incision of approximately 1 to 2 cm is made in the area under both armpits, and a curved correction rod (18) is inserted through the incision area as shown in Fig. 2(a) and Fig. 2(b).

[0011] The next step is to rotate the curved correction rod (18) in the direction of the arrow (A) of Fig. 2(a) and Fig. 2(b) so as to push out the sunken sternum (12) and costal cartilage (14) outward as shown in Fig. 2(c).

[0012] In this state, the next process is to observe for a while until the chest wall shape is corrected to a normal shape by supporting both ends of the correction bar (18) from the corresponding rib (10) portion.

[0013] In this way, the Nurse method, compared to the existing Ravitch method, leaves only a surgical scar of 1 to 2 cm on both sides of the chest, does not resect costal cartilage (14), and corrects the chest wall to form a normal shape, so it not only maintains the flexibility and elasticity of the chest, but also has the advantages of a short surgical time and less bleeding during surgery.

[0014] One of the important processes of this Nurse surgical method is that the insertion of the correction rod (18) must be done safely without damaging the body organs (20) such as the heart or lungs, as indicated by the dotted line in Fig. 3.

[0015] However, as shown in Fig. 3, the correction rod (18) has a limited elastic shape change due to a predetermined shape and size, and its insertion can only be done in the longitudinal direction of the correction rod (18). In addition, in patients with pectus excavatum, the degree of compression and firmness of the sternum (12) are relatively different, and there is a problem in that a space into which the correction rod (18) can be inserted is not formed.

[0016] Therefore, the conventional surgical method for correcting pectus excavatum deformity involves making an incision in the skin around the sternum (12), and then having some of the surgical staff insert a hook-shaped tool (not shown) into the incision site to separate the sternum (12) from the heart or lungs, and inserting a correction rod (18) into the space secured through this, and this process is continued until the correction rod (18) is safely inserted.

[0017] That is, the conventional surgical method required a separate medical staff to create a space between the sternum (12) and the body organs (20) for inserting the correction rod (18), and had the difficulty and inconvenience of continuously maintaining the sternum (12) in an elevated state for a long time to prevent secondary damage to the patient until the correction rod (18) was inserted.

[0018] The present invention has been made to solve the above-mentioned problems, and the purpose of the invention is to provide a medical screw structure for correcting pectus excavatum deformity, which facilitates securing space for inserting a correction rod between the sternum of a patient with pectus excavatum that compresses the lungs, which are respiratory organs, or the heart, which is a central organ of the circulatory system, and the heart, which is a central organ of the circulatory system, and prevents damage to bodily organs such as the heart or lungs continuously and stably until the insertion of the correction rod is completed, a surgical auxiliary device using the same, and a surgical method using the same.

[0019] In order to achieve the above purpose, the characteristic configuration of the medical screw structure for corrective surgery for pectus excavatum according to the present invention comprises: a head portion formed by bending an upper portion of a predetermined thickness and length to form a ring-shaped loop portion; a neck portion formed by extending vertically downward from the center of the loop portion to a predetermined length at the lower end of the head portion; and a body portion formed by continuously extending from the lower end of the neck portion and being bent downward in a spiral shape with a predetermined pitch along the circumferential direction and the vertical longitudinal direction with respect to the predetermined diameter.

[0020] In addition, the length of the neck may be less than or equal to the thickness of the sternum, and an elastic pad (37) may be further provided on the lower surface of the head (32) adjacent to the neck (34).

[0021] Meanwhile, a characteristic configuration of a surgical assisting device using a medical screw structure for corrective surgery for excavatum deformity to achieve the above purpose comprises: the medical screw structure (30); a hook (35) made of a metal material including an alloy and having a thickness and length smaller than the inner diameter of the ring portion (32a), and having one end and the other end in the longitudinal direction bent in the shape of the letter "S" to form a hook shape respectively; a bracket portion (42) provided on the side of an operating table (40); a traction support portion installed in the bracket portion, which is composed of a combination of a plurality of arms (54a, 54b, 58) that can be extended in each of vertical and horizontal directions; and a traction portion installed in the traction support portion, which guides the position of a traction line (39) having one end hooked to the hook (35) and winds and pulls or releases the other end.

[0022] In addition, the bracket portion (42) is installed on both sides of the operating table (40), and it is preferable that the bracket portions (42) on both sides further include a band portion for fixing a patient placed between them.

[0023] Meanwhile, a surgical method for correcting pectus excavatum deformity to achieve the above purpose comprises a surgical assist device using the medical screw structure for correcting pectus excavatum deformity, comprising: (A) a step of designing a fixation position and a traction position of the medical screw structure (30) based on scan information of the patient's body condition including the positional state of the patient's organs (20) and sternum (12); (B) a step of forming an insertion position (P1, P2) of the epidermis and a correction rod (18) corresponding to the fixation position of the medical screw structure (30) by incising the sternum (12) area corresponding to the fixation position of the medical screw structure (30); (C) a step of fixing the medical screw structure (30) to the sternum (12) by spreading the incised area; (D) a step of connecting a traction line (39) to the medical screw structure (30) and traction; (E) a step of peeling off a space for installing the correction rod (18) through the insertion positions (P1, P2) of the correction rod (18); and (F) a step of inserting the correction rod (18) through the insertion positions (P1, P2) into the space secured by the step (E).

[0024] According to the present invention, by pulling upward a plurality of medical screw structures fixed to the sternum of a pectus excavatum while the patient is fixed to the operating table so as to spread the space between the sternum and the organs, it is easy to return the sternum to a state of pectus excavatum and to be in a position where it is spread apart, and in addition, the force of spreading is stably maintained without change in strength in response to the force of restoring the sternum to a deformed position, and in addition, it is freely related to spreading or loosening as needed, so that a stable surgery can be performed without damage to the patient's organs.

[0025] Figure 1 is a front view showing the structure of the bones that make up the chest.

[0026] Figures 2a to 2c are schematic diagrams for explaining the process of correcting pectus excavatum deformity according to Nurse surgery.

[0027] Figure 3 is a perspective view schematically illustrating a medical screw structure according to the present invention.

[0028] Figure 4 is a schematic diagram explaining the conditions for installing a correction bar.

[0029] Figures 5 and 6 are perspective views and plan views schematically illustrating a surgical assist device set using the medical screw structure of Figure 4 and a surgical process using the same.

[0030] The characteristic configuration of the medical screw structure for corrective surgery for pectus excavatum deformity according to the present invention comprises: a head portion formed by bending an upper portion of a predetermined thickness and length to form a ring-shaped loop portion; a neck portion formed by extending vertically downward from the center of the loop portion to a predetermined length at the lower end of the head portion; and a body portion formed by continuously extending from the lower end of the neck portion and being bent downward in a spiral shape with a predetermined pitch along the circumferential direction and the vertical longitudinal direction with respect to the predetermined diameter.

[0031] Hereinafter, with reference to the attached drawings, a medical screw structure for corrective surgery for pectus excavatum deformity according to the present invention, a surgical auxiliary device set using the same, and a surgical method using the same will be described. The same parts as in the prior art are given the same reference numerals, and a detailed description thereof will be omitted.

[0032] First, the medical screw structure (30) for corrective surgery for pectus excavatum deformity according to the present invention, as shown in FIGS. 3a to 3c, is made of a rigid metal material including an alloy, and has a head portion (32) formed by bending a portion of the upper side into a ring shape while the longitudinal direction is placed in the up-down direction in a rod shape having a set thickness and length, and forming a ring portion (32a) on which a traction line (39) can be hung.

[0033] In addition, the medical screw structure (30) described above forms a neck (34) having a shape that extends from the lower end of the head (32) vertically downward from the central portion of the ring portion (32a) to a length already set in the vertical downward direction.

[0034] And the above-described medical screw structure (30) is formed by continuously extending from the lower end of the neck (34) to a length already set, and forming a body part (36) bent in a spiral shape with a pitch already set along the circumferential direction and the vertical length direction for the already set diameter as it goes downward.

[0035] Here, the lower end of the body part (36) described above has a sharp shape to facilitate digging into the sternum (12).

[0036] In addition, it is preferable that the body part (36) be formed with a set dimension in which the length of the lower portion is greater than the thickness of the sternum (12).

[0037] Meanwhile, in the above-described configuration, the neck (34) has a cylindrical shape fixed with the neck (34) as the central axis by receiving support between the head (32) and the body (36), as shown in FIGS. 3a to 3c, and has a support (35a) having a male screw formed on the outer circumferential surface.

[0038] In addition, the support part (35a) has a female screw formed on the inner surface in the shape of a pipe for screw connection with the support part (35a), and has a movable part (35b) whose upper and lower phases are determined based on the support part (35a) according to screw connection with the support part (35a).

[0039] The screw connection of the support part (35a) and the movable part (35b) determines the degree of protrusion of the body part (36) based on the lower position of the movable part (35b) according to the phase change.

[0040] In this way, the protrusion length of the body part (36) from the lower position of the movable part (35b) is determined by selecting one or more positions for lifting the sternum (12) among the sternum (12) based on information obtained by photographing the state of the patient's sternum (12) and body organs (20) before surgery, designating the optimal position for pulling the sternum (12) upward from this, incising the skin of each corresponding position, and using a separate tool for each incision position to fix the medical screw structure (30) by digging into the sternum (12), to determine the depth at which the body part (36) digs into the sternum (12).

[0041] That is, as shown in FIG. 4, the body part (36) of the medical screw structure (30) digs into the sternum (12) by rotating along the screw direction while applying a force in a direction perpendicular to the surface of the corresponding portion of the sternum (12), and the depth is limited to a position where the lower part of the movable part (35b) that rotates together with the body part (36) touches the upper surface of the corresponding sternum (12).

[0042] Here, the above-described movable part (35b) requires a means for fixing it to the support part (35a) so that the phase does not change after determining the phase based on the support part (35a) to correspond to the insertion depth of the body part (36) into the sternum (12).

[0043] An example of such a means is, as illustrated in FIG. 3a, a plurality of positioning grooves (35c) are formed along the outer circumference of the support portion (35a), and one or more holes penetrating inwardly and outwardly are formed on the outer circumference of the movable portion (35b), and after determining the phase of the movable portion (35b) with respect to the support portion (35a), a fixing pin (35d) is inserted from the outer side of the movable portion (35b) through the above-described through-hole so that the tip of the fixing pin (35d) is fitted into the above-described positioning groove (35c), thereby fixing the position of the movable portion (35b) with respect to the support portion (35a).

[0044] The change in the protrusion length of the body part (36) according to this is the same as the change in the difference (D↔Dd) between the lower end of the movable part (35b) and the lower end of the body part (36), as shown in FIGS. 3a and 3b.

[0045] In addition, the body part (36) described above needs to be inserted in a direction perpendicular to the surface of the sternum (12).

[0046] As a method for this, as shown in Fig. 3c, one or more protrusions (35e) are formed on the outer surface of the movable part (35b) described above, and a guide member (37) is separately provided in which the protrusions (35e) described above are fitted into the inner wall in a tubular shape through which the movable part (35b) can pass, thereby forming a guide groove (37a) having a spiral shape with the same pitch as the spiral shape of the body part (36) described above.

[0047] According to this, when the lower end of the guide member (37) is first positioned in close contact with the target area of ​​the sternum (12) and the movable member (35b) is fixed to the support member (35a) and inserted into the guide member (37), the protrusion (35e) of the body part (36) descends under the guidance of the guide groove (37a), and the pitch of the guide groove (37a) and the spiral pitch formed by the body part (36) are matched, so that the body part (36) is vertically embedded in the upper surface of the sternum (12).

[0048] In addition, the lower part of the above-described movable part (35b) may be further provided with an elastic pad (not shown) that can be elastically deformed, such as silicone.

[0049] In addition, the ring portion (32a) formed in the head portion (32) of the medical screw structure (30) is intended to allow one end of a towing line (39) or a hook (not shown) that fixes the towing line (39) to be hung.

[0050] Accordingly, the diameter of the ring portion (32a) is formed to a size capable of fixing the towing line (39), but it is desirable to design it to a level that ensures durability and rigidity so that it can sufficiently withstand the force resulting from towing through the section between the ring portions (32a) where the upper and lower portions of the head portion (32) are connected.

[0051] And, although the shape of the head (32) of the medical screw structure (30) is expressed as a circle in the drawing, it is not limited to this, and it can be manufactured in various shapes such as polygonal or oval.

[0052] Meanwhile, a surgical assist device using a medical screw structure for corrective surgery of thorax deformity to achieve the above purpose, as shown in FIGS. 5 and 6, comprises the medical screw structure (30) described above and a hook (35) made of a metal material including an alloy and having a lengthwise end portion formed in a hook shape with a thickness capable of penetrating the above-described ring portion (32a).

[0053] The above-described hook may have various shapes, but its purpose is to enable easy connection of a towing line (39) to a ring portion (32a) formed in a medical screw structure (30).

[0054] In addition, the surgical assistance device includes a bracket provided on the side of the operating table (40), a traction support unit installed on the bracket unit and composed of a combination of multiple arms (54a, 54b, 58) that can be extended in each of the vertical and horizontal directions, and a traction unit installed on the traction support unit to guide the position of a traction line (39) having one end fixed or hooked to the other end of a hook (35) and to wind and pull or release the other end portion.

[0055] Here, the above-described bracket part is preferably installed on both sides of the operating table (40), and its installation form is preferably positioned close to the operating table (40) so as to secure space for the medical practitioner to perform the procedure.

[0056] Looking at the configuration of this bracket part, as shown in Fig. 5, two or more brackets (42) that are fixed to the side of the operating table (40) using a fixing handle (Ta) or the like and a fixing screw (42a) can be provided at intervals along the side length direction of the operating table (40).

[0057] In addition, the bracket part may be configured to include a bracket support bar (44) that is fixed and supported by the above-described bracket (42).

[0058] It is preferable that these bracket support bars (44) be formed in a shape having a length in the direction of the side length of the operating table (40).

[0059] In addition, the traction support unit constituting the surgical assistance device is provided with a mount (52) whose position and installation are performed along the longitudinal direction with respect to the above-described bracket support bar (44), and the mount (52) is provided with a vertical arm (54a, 54b) that forms a shape that is generally erected vertically when installed with respect to the bracket support bar (44).

[0060] Here, the vertical rock (54a, 54b) may be configured in a general form in which the length can be changed in the up-down direction, and may also be configured in a form further provided with a fixing member (56a) for fixing the state with respect to the adjustment of the change in length.

[0061] In addition, a horizontal arm (58) is installed on the upper portion of the vertical arm (54a, 54b) described above, and the installation portion of the vertical arm (54a, 54b) and the horizontal arm (58) may be configured to further include a conventional structure and a fixing member (56b) that enable the horizontal arm (58) to rotate and move in the longitudinal direction of the horizontal arm (58) with respect to the vertical arm (54a, 54b).

[0062] And the traction part constituting the surgical assistance device is configured to be supported by at least the horizontal arm (58) among the vertical arms (54a, 54b) and horizontal arms (58) constituting the above-described traction support part, so that one end can be pulled up or released through the other end of the traction line (39) that is fixed to the other end of the hook (35), and also to be configured to fix the state in which the tension of the traction line (39) is maintained.

[0063] An example configuration for such a towing unit may be configured such that a reel (68) is installed on the upper portion of a vertical arm (54a, 54b) to enable winding or unwinding of the towing line (39) while fixing the other end of the towing line (39), and the vertical arm (54a, 54b) on which the reel (68) is installed may be provided with a means such as a ratchet portion (66) for controlling the rotation of the reel (68).

[0064] In addition, as shown in Fig. 5, the tip of the horizontal rock (58) described above may be provided with a guide finger (64) and a guide roller (62) to guide the towing line (39).

[0065] In addition, the above-described bracket part may further include a band part for fixing the patient to the bracket (42) installed on both sides of the operating table (40).

[0066] This band section is configured as a means for fixing a patient when the traction force for displacement of the sternum (12) is greater than the patient's body weight during the process of traction of the sternum (12) through the above-described traction section for a patient placed on an operating table (40).

[0067] An example of the band section described above can be installed in a manner in which both ends of a belt (70) are fixed to bracket support bars (44) installed on both sides of an operating table (40) using means such as a belt fixing member (72), as shown in FIGS. 5 and 6, thereby preventing a patient placed on an operating table (40) between them from being lifted upward.

[0068] Meanwhile, the surgical method for correcting pectus excavatum deformity to achieve the above-described purpose designs the fixation position and traction position of the medical screw structure (30) based on the patient's body condition scan information, including the position of the patient's body organs (20) and sternum (12), obtained using MRI, CT, ultrasound, etc. prior to the surgery (step (A)).

[0069] Among the scan information described above, the patient's body condition scan using ultrasound can be performed continuously during the surgical process.

[0070] Based on the design obtained from this, the operator incises the skin of the sternum (12) area corresponding to the fixation location of the medical screw structure (30) and the insertion location (P1, P2) of the correction rod (18) (step (B)).

[0071] Then, the surgeon opens the incised area for fixing the medical screw structure (30) and fixes the medical screw structure (30) to the sternum (12) (step (C)), and connects a traction line (39) to the medical screw structure (30) (step (D)).

[0072] At this time, the direction of traction for one medical screw structure (30), i.e., the design direction for traction according to the pre-scan before surgery, may be a direction that is difficult to achieve through one surgical assistance device, and the installation location of the surgical assistance device may be in a location that is an obstacle to the surgeon performing the surgery.

[0073] In this regard, it is desirable to install multiple surgical assist devices within a range that does not interfere with the surgeon's procedure before the surgery, and to induce traction in the direction that is the vector sum of the traction directions by hooking each hook (35) connected to two or more surgical assist devices to one medical screw structure (30).

[0074] And since the hooks (35) described above are connected in a form that penetrates the ring portion (32a) formed in the medical screw structure (30), it is easy to collect the vector sum of the traction direction based on each auxiliary device.

[0075] This is because the above-described ring parts (32a) are formed in a shape that intersects each other and is close to the upper center of the neck part (34) that is fixed to the sternum (12).

[0076] From this, when the patient's condition is such that the correction rod (18) can be inserted by traction of the sternum (12), the operator performs a procedure including a peeling process to secure space for installing the correction rod (18) through the insertion positions (P1, P2) of the correction rod (18) and a process (step (E)) of inserting the correction rod (18) through the insertion positions (P1, P2) into the secured space.

[0077] As seen above, it can be seen that the present invention can be achieved by the structure of a medical screw structure (30) for temporarily (for example, for the time required to perform a procedure) setting the position of the sternum (12) through a surgical assist device outside the patient's body.

Claims

1. A medical screw structure for corrective surgery for cubitus thorax, comprising: a head portion (32) formed by bending an upper portion of a previously set thickness and length to form a ring-shaped ring portion (32a); a neck portion (34) formed by extending vertically downward from the center of the ring portion (32a) to a previously set length at the lower end of the head portion (32); and a body portion (36) formed by continuously extending from the lower end of the neck portion (34) and being bent downward in a spiral shape with a previously set pitch along the circumferential direction and the vertical length direction with respect to the previously set diameter.

2. In paragraph 1, A medical screw structure for corrective surgery for cubitus thorax, characterized in that it further comprises a support part (35a) having a cylindrical shape fixed with the neck part (34) as a central axis by receiving support between the head part (32) and the body part (36), and having a screw formed on the outer circumference; and a movable part (35b) having a pipe shape and having a screw formed on the inner circumference for screw fastening with the support part (35a), and determining the upper and lower positions based on the support part (35a), and determining the protruding length of the body part (36) based on the lower position.

3. A surgical assist device using a medical screw for corrective surgery for pectus excavatum, comprising: a medical screw (30) of the above-mentioned first paragraph; a hook (35) having a thickness and length equal to or less than the inner diameter of the ring (32a) at least at one end in the longitudinal direction and formed in a hook shape, made of a metal material including an alloy; a bracket (42) provided on the side of an operating table (40); a traction support part installed on the bracket part, which is composed of a combination of a plurality of arms (54a, 54b, 58) that can be extended in each of the vertical and horizontal directions; and a traction part installed on the traction support part, which guides the position of a traction line (39) hooked on the hook (35) at one end and winds and pulls or releases the other end.

4. In paragraph 3, A surgical assist device using a medical screw for corrective surgery for cubitus thorax deformity, wherein the above bracket portion (42) is installed on both sides of the above operating table (40), and the above bracket portions (42) on both sides are further provided with a band portion for fixing a patient placed between them.

5. A surgical assist device using a medical screw for corrective surgery for pectus excavatum deformity of the above-mentioned third or fourth clause is provided, and (A) a step of designing a fixation position and a traction position of the medical screw (30) based on scan information of the patient's body condition including the positional state of the patient's organs (20) and sternum (12); (B) a step of forming an insertion position (P1, P2) of the epidermis and a correction rod (18) corresponding to the fixation position of the medical screw (30) by incising the sternum (12) area corresponding to the fixation position of the medical screw (30); (C) a step of fixing the medical screw (30) to the sternum (12) by spreading the incised area; (D) a step of connecting a traction line (39) to the medical screw (30) and traction; (E) A surgical method for correcting cubitus excavatum, comprising the step of inserting the correction rod (18) through the insertion position (P1, P2) into the secured space.

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