CN110464432B - Surgical instrument used in conjunction with arthroscopy - Google Patents
Surgical instrument used in conjunction with arthroscopy Download PDFInfo
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- CN110464432B CN110464432B CN201910845395.8A CN201910845395A CN110464432B CN 110464432 B CN110464432 B CN 110464432B CN 201910845395 A CN201910845395 A CN 201910845395A CN 110464432 B CN110464432 B CN 110464432B
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- sleeve
- outer sheath
- sheath tube
- core rod
- surgical instrument
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- 230000006835 compression Effects 0.000 claims abstract description 12
- 238000007906 compression Methods 0.000 claims abstract description 12
- 230000000903 blocking effect Effects 0.000 claims abstract description 4
- 230000002093 peripheral effect Effects 0.000 claims description 3
- 238000003032 molecular docking Methods 0.000 claims 1
- 238000001356 surgical procedure Methods 0.000 abstract description 8
- 206010015866 Extravasation Diseases 0.000 abstract description 7
- 230000036251 extravasation Effects 0.000 abstract description 7
- 230000010412 perfusion Effects 0.000 abstract description 5
- 230000000694 effects Effects 0.000 abstract description 3
- 239000012530 fluid Substances 0.000 abstract description 3
- 208000035965 Postoperative Complications Diseases 0.000 abstract description 2
- 230000009286 beneficial effect Effects 0.000 abstract description 2
- 239000000463 material Substances 0.000 abstract 1
- 210000001519 tissue Anatomy 0.000 description 6
- 210000003491 skin Anatomy 0.000 description 5
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 description 4
- 210000000281 joint capsule Anatomy 0.000 description 4
- 210000005257 cortical tissue Anatomy 0.000 description 3
- 238000000034 method Methods 0.000 description 3
- 206010034754 petechiae Diseases 0.000 description 3
- 239000011780 sodium chloride Substances 0.000 description 3
- 230000036772 blood pressure Effects 0.000 description 2
- 210000003414 extremity Anatomy 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 238000012544 monitoring process Methods 0.000 description 2
- 239000000243 solution Substances 0.000 description 2
- 208000032843 Hemorrhage Diseases 0.000 description 1
- 206010064091 Iatrogenic infection Diseases 0.000 description 1
- 206010047513 Vision blurred Diseases 0.000 description 1
- 210000003423 ankle Anatomy 0.000 description 1
- 208000034158 bleeding Diseases 0.000 description 1
- 230000000740 bleeding effect Effects 0.000 description 1
- 238000011109 contamination Methods 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 230000009977 dual effect Effects 0.000 description 1
- 210000001513 elbow Anatomy 0.000 description 1
- 210000002615 epidermis Anatomy 0.000 description 1
- 238000002695 general anesthesia Methods 0.000 description 1
- 238000007373 indentation Methods 0.000 description 1
- 238000001802 infusion Methods 0.000 description 1
- 210000001503 joint Anatomy 0.000 description 1
- 210000003127 knee Anatomy 0.000 description 1
- 230000000399 orthopedic effect Effects 0.000 description 1
- 230000003204 osmotic effect Effects 0.000 description 1
- 239000002504 physiological saline solution Substances 0.000 description 1
- 230000002980 postoperative effect Effects 0.000 description 1
- 238000000926 separation method Methods 0.000 description 1
- 210000004872 soft tissue Anatomy 0.000 description 1
- 230000008961 swelling Effects 0.000 description 1
- 208000011580 syndromic disease Diseases 0.000 description 1
- 210000000707 wrist Anatomy 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/34—Trocars; Puncturing needles
- A61B17/3468—Trocars; Puncturing needles for implanting or removing devices, e.g. prostheses, implants, seeds, wires
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/34—Trocars; Puncturing needles
- A61B17/3478—Endoscopic needles, e.g. for infusion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/0034—Surgical instruments, devices or methods for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means adapted to be inserted through a working channel of an endoscope
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B2017/3419—Sealing means between cannula and body
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Pathology (AREA)
- Endoscopes (AREA)
- Surgical Instruments (AREA)
Abstract
本发明公开了一种与关节镜配合使用的手术器械，设置了套管、带有锥尖头的套芯杆和塑料材质的外鞘筒；所述外鞘筒套装在套管两端之间，在外鞘筒右部设有改变外鞘筒长度的压缩折叠区，套管右端设有阻挡外鞘筒右端的凸台肩，所述套芯杆位于套管内部并将锥尖头伸出到套管右端部的外面。其有益技术效果是：不仅解决了关节灌注液外渗至组织间隙的问题，可同时将套管装置牢牢固定在关节腔内，解决了因术中反复更换关节镜器械导致套管系统滑出的问题。使得手术操作方便简单，大大节约了手术时间，有效降低了术后并发症发生率。
The present invention discloses a surgical instrument used in conjunction with an arthroscopy, which is provided with a sleeve, a sleeve core rod with a conical tip, and an outer sheath tube made of plastic material; the outer sheath tube is sleeved between the two ends of the sleeve, a compression folding area for changing the length of the outer sheath tube is provided on the right part of the outer sheath tube, a boss shoulder for blocking the right end of the outer sheath tube is provided on the right end of the sleeve, and the sleeve core rod is located inside the sleeve and extends the conical tip outside the right end of the sleeve. The beneficial technical effect is: it not only solves the problem of joint perfusion fluid extravasation into the tissue gap, but also can firmly fix the sleeve device in the joint cavity, and solves the problem of the sleeve system slipping out due to repeated replacement of arthroscopic instruments during surgery. It makes the surgical operation convenient and simple, greatly saves the operation time, and effectively reduces the incidence of postoperative complications.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a surgical instrument matched with an arthroscope.
Background
In recent years, arthroscopic surgery has been widely used in the field of orthopedics and sports medicine. The arthroscope which is commonly used in clinic at present controls capillary hemorrhage in the joint cavity through physiological saline perfusion, so that a satisfactory scope view is obtained. Continuous saline infusion requires that the joint cavity be a relatively tight space, which is often easily achieved in simple single or dual channel arthroscopic surgery. However, complex arthroscopic surgery often requires multiple arthroscopic channels to be established, and frequent switching between the viewing channel and the operative channel is required during surgery, where extravasation of saline perfusate becomes a "rate limiting" element that limits the smooth progress of the surgery.
In theory, the extravasation of saline perfusate can lead to several problems including 1. Reduced perfusion pressure in the joint cavity, increased capillary hemorrhage, blurred vision under the scope, 2. Reduced volume of the joint cavity, reduced operating space, 3. Swelling of the interstitial spaces outside the joint cavity, increased incidence of postoperative osteofascial syndrome, 4. Separation of the epidermis incision and the joint capsule incision due to extravasation of perfusate into the interstitial spaces, reduced patency of arthroscope channels, 5. Massive extravasation of joint perfusate, contamination of the operating table, and easy iatrogenic infection.
In order to reduce the extravasation of normal saline perfusate, capillary hemorrhage can be clinically reduced by using a tourniquet, but the method is only suitable for arthroscopy operation of distal limbs such as knee, ankle, elbow and wrist, and the use time of the tourniquet is strictly limited, usually not more than 1.5 hours, otherwise, the bleeding complications of the limb after operation are easily caused. In addition, for operations such as hip and shoulder, which cannot use tourniquets, a method of controlling blood pressure reduction in general anesthesia is generally used clinically to reduce capillary osmotic pressure, but the method can cause the craniocerebral blood pressure of a patient to be reduced, so that the operation time is also severely limited.
In order to solve the problems, a special matched instrument for arthroscopic surgery, which is convenient to use, simple in structure, safe and practical, needs to be developed, and is one of the tasks to be completed in the current field.
Disclosure of Invention
The technical problem to be solved by the invention is to provide a surgical instrument matched with an arthroscope, which can prevent perfusion fluid from leaking out of the body or tissue gaps in arthroscope operation, and has the characteristics of ensuring the smoothness of arthroscope channels and thoroughly eliminating negative influence of the perfusion fluid leaking out in arthroscope operation on operation.
The technical scheme includes that the surgical instrument matched with the arthroscope comprises a sleeve, a sleeve rod with a conical tip and an outer sheath tube made of plastic, wherein the outer sheath tube is sleeved between two ends of the sleeve, a compression folding area for changing the length of the outer sheath tube is arranged at the right part of the outer sheath tube, a convex shoulder for blocking the right end of the outer sheath tube is arranged at the right end of the sleeve, and the sleeve rod is positioned in the sleeve and extends the conical tip out of the right end of the sleeve.
The compression folding region is a plurality of transverse slits uniformly distributed on the peripheral surface of the right part of the outer sheath tube, and the transverse slits are compressed to generate folding deformation by the right thrust of the left side of the outer sheath tube.
The surgical instrument matched with the arthroscope for use further comprises an adjusting handle and a branch pipe, wherein the adjusting handle is arranged at the left end of the outer sheath barrel, a curved end face is arranged at the left end of the adjusting handle, the branch pipe is further arranged at the left part of the sleeve, the curved end face is in contact with the outer peripheral face of the branch pipe, and an annular boss in butt joint with the sleeve core rod is further arranged at the left end part of the sleeve.
The surgical instrument matched with the arthroscope further comprises a limit ring, wherein the limit ring is of a frustum shape made of plastic and provided with a central hole, and the limit ring is sleeved on the sleeve between the adjusting handle and the compression folding area.
The surgical instrument matched with the arthroscope is characterized in that the branch pipe is provided with a valve communicated with the inside of the sleeve, and the valve is provided with a connecting belt connected with the sleeve.
According to the surgical instrument matched with the arthroscope, the left end of the sleeve core rod is provided with the clamping end head and the base circular plate for limiting the connection depth of the sleeve, and the triangular tail fin is arranged between the clamping end head and the base circular plate.
The invention provides a surgical instrument matched with an arthroscope, which is provided with a sleeve, a sleeve rod with a conical tip and an outer sheath tube made of plastic, wherein the outer sheath tube is sleeved between two ends of the sleeve, a compression folding area for changing the length of the outer sheath tube is arranged at the right part of the outer sheath tube, a convex shoulder for blocking the right end of the outer sheath tube is arranged at the right end of the sleeve, and the sleeve rod is positioned in the sleeve and extends the conical tip out of the right end of the sleeve. The device has the beneficial technical effects that the conical tip is utilized to penetrate into the joint cavity through the operation knife edge to penetrate into the joint capsule, the left end of the outer sheath tube is pushed to push the adjusting handle, so that the transverse slotting part is compressed to generate folding deformation, skin tissues between the compression folding area and the limiting ring are compressed, the problem that joint perfusate is infiltrated into a tissue gap is solved, the device can be firmly fixed in the joint cavity at the same time, and the problem that a sleeve system slides out due to repeated replacement of arthroscope instruments in operation is solved. The operation is convenient and simple, the operation time is greatly saved, and the occurrence rate of postoperative complications is effectively reduced.
Drawings
FIG. 1 is a schematic diagram of the structure of the present invention;
FIG. 2 is a schematic view of a sleeve structure according to the present invention;
FIG. 3 is a schematic view of the outer sheath of the present invention;
FIG. 4 is a schematic view of a stop collar according to the present invention;
FIG. 5 is a schematic view of a core rod structure according to the present invention;
FIG. 6 is a schematic view of the structure of the outer sheath tube with the limit ring sleeved on the sleeve;
FIG. 7 is a schematic view of the structure of the invention, wherein the structure is that the adjusting handle is pushed rightwards to compress and generate folding deformation at the transverse slit;
FIG. 8 is a schematic view of the present invention in a state of entry or exit from the cortical tissue of a patient through an operative incision;
fig. 9 is a schematic view of the structure of the present invention with the adjustment knob pushed to the right to compress the patient's cortical tissue by the stop collar and compression fold.
The reference numerals of all the components in the figure are a triangular tail wing 1, a clamping end head 2, a base circular plate 3, a branch pipe 4, a valve 5, a connecting belt 6, an outer sheath barrel 7, a compression folding area 8, a boss shoulder 9, a conical tip 10, a transverse slit 11, a folding indentation 12, a limit ring 13, an adjusting handle 14, a curve end face 15, a sleeve 16, a sleeve rod 17, a patient cortex tissue 18, an operation knife edge 19 and an annular boss 20.
Detailed Description
For the purpose of making the objects, technical solutions and advantages of the embodiments of the present invention more apparent, the technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present invention, and it is apparent that the described embodiments are some embodiments of the present invention, but not all embodiments of the present invention. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.
As shown in fig. 1 to 9, the working principle of the present invention is described below with reference to the accompanying drawings:
In the initial state (see fig. 1), the sleeve core rod 17 is positioned in the sleeve 16, and the straight-line-shaped strip on the base circular plate 3 is matched with the straight-line-shaped groove arranged in the annular boss 20 to complete seamless connection. The outer sheath 7 is initially closed and the valve 5 is likewise in a closed condition.
Secondly, the instrument of the invention is put in (see fig. 8 and 9), a surgical knife 19 is firstly cut on the skin of a patient by using a surgical knife, then the instrument of the invention in an initial state is penetrated into the skin by the surgical knife 19, and the joint capsule is penetrated into the joint cavity by using the conical tip 10. Next, the position and depth of the instrument of the present invention is determined under arthroscopic monitoring. The adjusting handle 14 is pushed rightwards to enable the compression folding area 8 positioned in the surgical knife edge 19 to be in an unfolding state, at the moment, the length of the outer sheath tube 7 is shortened, the curve end face 15 of the adjusting handle 14 is kept in contact with the branch pipe 4, and the curve end face 15 is stably propped against. Next, the stop collar 13 is slid to the right along the outer sheath tube 7 until it is confirmed that the stop collar 13 compresses the patient cortical tissue 18 with the compressed fold 8 in the expanded state, preventing extravasation of perfusate outside the body or tissue space during arthroscopic surgery. Finally, the core rod 17 is pulled out of the sleeve 16,
Third, during the surgical operation (see fig. 7), other arthroscopic instruments may directly enter the joint cavity via the unidirectional opening and closing piston disposed inside the cannula 16. When the pressure in the joint cavity is too high, part of joint perfusate can be released through the valve 5 to regulate the pressure. In addition, because the instrument is directly communicated with the inside and the outside of the joint cavity, the external knot can be smoothly sent into the joint cavity through the center of the sleeve 16, thereby effectively avoiding the incarceration effect caused by the possible knot of soft tissues around the arthroscope channel, greatly simplifying the operation steps and saving the operation time.
Fourth, after the operation is finished, the sleeve rod 17 is firstly replaced in the sleeve 16, and the adjusting handle 14 is pulled leftwards under the monitoring of the arthroscope, so that the transverse slit 11 of the outer sheath tube 7 is closed. And simultaneously, the limit ring 13 is moved leftwards, the tissue gap between the joint capsule and the skin is loosened, and the instrument is slowly pulled out of the body. Finally, the skin is sutured, and the operation is completed.
Those skilled in the art can also make appropriate changes and modifications to the above-described embodiments in light of the disclosure and teachings of the above specification. Therefore, the invention is not limited to the specific embodiments disclosed and described above, but some modifications and changes of the invention should be also included in the scope of the claims of the invention. In addition, although specific terms are used in the present specification, these terms are for convenience of description only and do not limit the present invention in any way.
Claims (3)
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201910845395.8A CN110464432B (en) | 2019-09-05 | 2019-09-05 | Surgical instrument used in conjunction with arthroscopy |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201910845395.8A CN110464432B (en) | 2019-09-05 | 2019-09-05 | Surgical instrument used in conjunction with arthroscopy |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN110464432A CN110464432A (en) | 2019-11-19 |
| CN110464432B true CN110464432B (en) | 2025-01-10 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201910845395.8A Active CN110464432B (en) | 2019-09-05 | 2019-09-05 | Surgical instrument used in conjunction with arthroscopy |
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| CN (1) | CN110464432B (en) |
Families Citing this family (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN112587177A (en) * | 2020-12-09 | 2021-04-02 | 北京世通瑞泰医疗器械有限公司 | Temporomandibular arthroscope instrument matched with temporomandibular arthroscope for use |
Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN201727547U (en) * | 2010-06-30 | 2011-02-02 | 中国人民解放军第三军医大学第一附属医院 | Arthroscope channel protective sheath catheter |
| CN105962999A (en) * | 2016-04-20 | 2016-09-28 | 中国人民解放军第四军医大学 | Petal-shaped damping puncture apparatus for anterior mediastinum minimally invasive surgery and using method of puncture apparatus |
| CN211066917U (en) * | 2019-09-05 | 2020-07-24 | 北京积水潭医院 | A surgical instrument used in conjunction with an arthroscope |
Family Cites Families (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US7413542B2 (en) * | 2004-01-29 | 2008-08-19 | Cannuflow, Inc. | Atraumatic arthroscopic instrument sheath |
| US7445596B2 (en) * | 2004-01-29 | 2008-11-04 | Cannuflow, Inc. | Atraumatic arthroscopic instrument sheath |
| CN103431835A (en) * | 2013-08-09 | 2013-12-11 | 广州宝胆医疗器械科技有限公司 | Arthroscope with inflation air bags |
-
2019
- 2019-09-05 CN CN201910845395.8A patent/CN110464432B/en active Active
Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN201727547U (en) * | 2010-06-30 | 2011-02-02 | 中国人民解放军第三军医大学第一附属医院 | Arthroscope channel protective sheath catheter |
| CN105962999A (en) * | 2016-04-20 | 2016-09-28 | 中国人民解放军第四军医大学 | Petal-shaped damping puncture apparatus for anterior mediastinum minimally invasive surgery and using method of puncture apparatus |
| CN211066917U (en) * | 2019-09-05 | 2020-07-24 | 北京积水潭医院 | A surgical instrument used in conjunction with an arthroscope |
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| Publication number | Publication date |
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| CN110464432A (en) | 2019-11-19 |
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| CB02 | Change of applicant information |
Country or region after: China Address after: 100035 No. 31 East Xinjiekou street, Beijing, Xicheng District Applicant after: Beijing Jishuitan Hospital Affiliated to Capital Medical University Address before: Sports Injury Department, Beijing Jishuitan Hospital, No. 31 Xinjiekou East Street, Xicheng District, Beijing 100035 Applicant before: BEIJING JISHUITAN Hospital Country or region before: China |
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