CN107669318A - A kind of intracerebral sight glass guiding device - Google Patents

Abstract

The invention discloses a brain endoscope guiding device, which comprises a directional guiding trocar and a guider, the guider has a through hole whose aperture gradually becomes smaller from top to bottom, and the directional guiding trocar includes a puncture A guide needle and a sheath, wherein the sheath passes through the through hole sequentially from top to bottom, the puncture guide needle is inserted into the sheath from top to bottom, and the blunt end protrudes out of the sheath. The present invention first performs directional puncture through a guide needle with a transparent front end and a built-in camera lens, so as to guide the endoscope to advance to the target area of surgery along a preset path. Further, through the cooperation of the introducer and the sheath body, the endoscope can be guided to perform surgical operations in the surrounding area of the target area. The surrounding area is a tapered adjustable area with the puncture path as the central axis. The top of the tapered area is the thinnest part of the lower through hole of the introducer, and the thinnest part of the lower through hole of the introducer is moved down to the surface of the brain. After the puncture, the disturbance of the brain tissue is minimized and the observation range is maximized.

Description

A brain endoscope guiding device

technical field

The invention belongs to the field of medical equipment, and relates to a brain endoscope guiding device, which is used for three-dimensional guidance of the brain endoscope.

Background technique

At present, the commonly used stereotaxic instruments include Leksell orientation system, BRW/CRW orientation system, and Todd‐well orientation system; in China, there are ASA‐601 and 602 orientation instruments from Shenzhen Anke High-Tech Co., Ltd. The principle is that a frame needs to be installed outside the skull first, and then the frame and the patient are scanned by CT or MRI, and then the CT or MRI image of the patient's brain with frame coordinate parameters is obtained. The image anatomical structure will have a corresponding coordinate value in this coordinate system, and then use the puncture needle to puncture according to the mechanical data defined by the brain stereotaxic instrument, and establish a channel for the insertion of the brain endoscope. There is also a frameless stereotaxy, commonly known as neuronavigation, which uses body surface markers as a frame of reference and uses preoperative CT or MRI images to locate intracranial structures. Upper fixing device (ie: guide-stopper).

There are two types of brain endoscopes: 1. Observation mirror, which has a certain observation range to the front of the lens. Because there is only one optical path in the mirror body, it can be made relatively slender. 2. The ventriculoscope is not only used for observation, but also needs passages for liquid and surgical instruments to enter and exit, so it is thicker than the former.

Due to the complex structure of the brain and the limited resolution of anatomical images, ordinary puncture needles are used, and the puncture process is a blind operation, and the operator cannot foresee and deal with accidental injuries caused by puncture in a timely manner. In addition, due to the fixing effect of the guide and the stopper on the guide needle, it can only be used for treatment at a designated location, and cannot be extended to the surrounding environment.

Contents of the invention

The object of the present invention is to address the shortcomings of the prior art, and provide a brain endoscope guiding device, which is used for the stereotaxic orientation of the brain endoscope, and realizes the treatment of the surgical target area.

The purpose of the present invention is achieved through the following technical solutions: a brain endoscope guide device, including a directional guide trocar and a guide, the guide includes a positioning cap and a guide cone, and the positioning cap opens There is a central circular hole, the upper part of the guide cone is a cylindrical structure, the lower part is a rounded table structure, and the inside has a through hole whose aperture gradually decreases from top to bottom, and the diameter of the lower end of the through hole is the same as that of the central circular hole; the guide The upper edge of the vertebral body has a fillet, and the positioning cap has an inner fillet coupled with the upper edge of the guiding vertebral body;

The directional guide trocar includes a puncture guide needle and a sheath body, and the sheath body passes through the central circular hole and the through hole sequentially from top to bottom, and is clearance-fitted with the lower end of the through hole and the central circular hole. The puncture guide needle is inserted into the sheath from top to bottom, and the blunt end protrudes out of the sheath and transitions smoothly with the end of the sheath.

Further, the inside of the puncture guide needle is a hollow structure with a transparent end.

Further, the upper part of the puncture guide needle has a first annular protrusion with an outer diameter larger than the inner diameter of the sheath, so that the blunt end just protrudes outside the sheath and transitions smoothly with the end of the sheath.

Further, the wall of the central circular hole has a rubber ring for fixing the position of the sheath in the introducer.

Further, the sheath body has a second annular protrusion, and the outer diameter of the second annular protrusion is larger than the diameter of the central circular hole. The part of the sheath body above the second annular protrusion is an auxiliary sheath, and the part of the sheath body below the second annular protrusion forms a main sheath.

Further, the main sheath and the auxiliary sheath are designed separately.

The beneficial effects of the present invention are:

1. First, through the guide needle with a transparent front end and a built-in brain observation mirror, directional puncture is performed, so that the puncture process is under the full monitoring of the camera, and blocked blood vessels or bleeding can be found in time, so as to make immediate treatment and guide the brain endoscope along the preset direction The path of the catheter, the sheath channel, is advanced to the surgically targeted area.

2. The cooperation between the introducer and the sheath can guide the ventriculoscope to perform surgical operations on the target and surrounding areas. The surrounding area is a tapered adjustable area with the puncture path as the central axis. The top of the tapered area is the thinnest part of the through hole of the introducer. The guide is moved down to the surface of the brain. Optimized brain tissue perturbation to maximize the scope of observation and operation.

Description of drawings

Fig. 1 is the structural representation of brain endoscope guiding device;

Fig. 2 is a schematic structural view of the stereotaxic guide of the present invention;

Fig. 3 is the structural representation of positioning cap;

Fig. 4 is the structural representation of guide cone;

Fig. 5 is a schematic diagram of the rotation of the ventriculoscope in the stereotaxic guide;

Figure 6 is a schematic diagram of the combination of multiple main sheaths and auxiliary sheaths, where a is the puncture guide needle, b is the combination of the main sheath and the auxiliary sheath, and c is the directional guide trocar composed of the puncture guide needle and the sheath body designed separately schematic diagram.

In the figure, the puncture guide needle 1, the guide 2, the sheath body 3, the end 11, the first annular protrusion 12, the positioning cap 21, the guide cone 22, the central circular hole 23, the through hole 24, the second annular protrusion 31, auxiliary sheath 32, main sheath 33.

detailed description

As shown in Figure 1, a kind of endoscope guiding device comprises orientation guiding trocar and introducer 2, and described introducer 2 comprises positioning cap 21 and guiding cone 22, as shown in Figure 2, described The positioning cap 21 is a round cover with a radian, the radius of which is consistent with the height of the guide cone 22, and has a central circular hole 23. The upper part of the guide cone 22 is a cylindrical structure, and the lower part is a rounded platform structure. The inside has an aperture from top to bottom. The lower through hole 24 gradually becomes smaller, and the diameter of the lower end of the through hole 24 is the same as that of the central circular hole 23; Inner fillet; the directional guide trocar includes a puncture guide needle 1 and a sheath 3, and the sheath 3 passes through the central circular hole 23 and the through hole 24 sequentially from top to bottom, and is connected with the lower end of the through hole 24 and the The central circular hole 23 is clearance fit. The puncture guide needle 1 is inserted into the sheath body 3 from top to bottom, and the blunt end 11 protrudes outside the sheath body 3 and smoothly transitions with the end of the sheath body 3 .

Guidance of the ventriculoscope includes puncture to determine the insertion path of the ventriculoscope, and multi-directional guidance for expansion of the surrounding area.

The puncture steps are as follows: fix the introducer 2 on the existing stereotaxic instrument, determine the puncture path through the guide and the stopper included in the stereotaxic instrument, and the upper part of the guide cone 2 is a cylindrical structure, so that it It is suitable for the guide base of the existing stereotaxic instrument, and the lower part is a rounded table structure, which is convenient for aligning to the designated part. Then the brain observation mirror is inserted into the inside of the puncture guide needle 1, so that the lens at the front end overlaps with the transparent end of the puncture guide needle 1, so that the observation operation can be performed. Then insert the puncture guide needle 1 into the sheath body 3 from top to bottom, the puncture guide needle 1 and the sheath body 3 form a directional guiding trocar, wherein the blunt and transparent end 11 of the puncture guide needle 1 protrudes outside the sheath body 3 , and a smooth transition with the end of the sheath body 3. Then the complex of the trocar and the brain observation mirror is inserted into the stopper into the guide 2 sequentially from top to bottom, passes through the central circular hole 23 and the through hole 24 successively, and is connected with the lower end of the through hole 24 and the central circle. The hole 23 is a clearance fit. During the puncture process, the puncture process can be monitored throughout, including observing the shape of the intracranial hematoma.

According to the location of the hematoma, the sheath body 3 needs to extend forward for a certain length to construct an operation channel extending to the hematoma location for the subsequent use of the ventriculoscope, that is, the relative position of the sheath body 3 and the introducer 2 needs to be fixed. Fixed methods include:

(1) A rubber ring is installed on the wall of the central circular hole 23, and the positioning is performed by friction.

(2) The sheath body 3 has a second annular protrusion 31 , and the outer diameter of the second annular protrusion 31 is larger than the diameter of the central circular hole 23 . The part of the sheath above the second annular protrusion 31 is the auxiliary sheath 32 , and the part of the sheath below the second annular protrusion 31 forms the main sheath 33 . Fig. 6 shows a combination of multiple main sheaths 33 and auxiliary sheaths 32, which are suitable for different lesion depths. The total lengths of the main sheath 33 and auxiliary sheath 32 in various combinations are the same, so that they match the length of the puncture guide needle 1 to ensure that the blunt round end 11 of the puncture guide needle 1 just protrudes outside the sheath body 3 .

In order to reduce the damage to the brain tissue during the puncture, the puncture guide needle 1 needs to have a blunt end 11, and the blunt end 11 just protrudes outside the sheath 3, and smoothly transitions with the end of the sheath 3. Therefore, in The upper part of the puncture guide needle 1 is provided with a first annular protrusion 12 whose outer diameter is larger than the inner diameter of the sheath body 3 , so as to realize the cooperation between the puncture guide needle 1 and the end of the sheath body 3 .

The multi-directional guidance steps are as follows: after the puncture is completed, remove the stopper, pull out the brain observation mirror together with the puncture guide needle 1, insert the ventriculoscope into the sheath 3, and extend the ventriculoscope to the target area along the treatment channel. The inside of the introducer 2 has a through hole 24 whose diameter gradually decreases from top to bottom, and the sheath 3 located in the through hole 24 can turn around along the side wall of the through hole 24, as shown in FIG. 5 . The lumen of the guide cone 2, that is, the through hole 21 that gradually decreases from top to bottom can provide a cone-shaped adjustable space for the ventriculoscope, and the mirror body of the ventriculoscope located in the sheath body 3 is located at the center of the tapered space. When the top is close to the surface of the brain, no matter how the lens at the front end is adjusted, the lens will cause little disturbance to the surface of the brain. As the depth of the lens penetrates into the brain tissue increases, the adjustable space becomes larger, that is, the deeper the lesion , the larger the observation range, so as to minimize the disturbance of brain tissue and obtain the maximum observation range.

And when you lose your way during the operation, you only need to slide the positioning cap 21 to the coupling position of the guide cone 22, and the ventriculoscope will return to the original puncture path. Visual assessment. The rounded corner design can avoid the problem of the guide pin being locked when it moves.

Claims (6)

1. A brain endoscope guiding device is characterized in that it comprises a directional guide trocar and a guide (2), and the guide (2) includes a positioning cap (21) and a guide cone (22) , the positioning cap (21) has a central circular hole (23), the upper part of the guide cone (22) is a cylindrical structure, the lower part is a rounded table structure, and the inside has a through hole (24) whose aperture gradually becomes smaller from top to bottom. ), and the diameter of the lower end of the through hole (24) is the same as that of the central circular hole (23); coupled fillets; The directional guiding trocar comprises a puncture guide needle (1) and a sheath (3), and the sheath (3) passes through the central circular hole (23) and the through hole (24) sequentially from top to bottom, and is compatible with the The lower end of the through hole (24) is in clearance fit with the central circular hole (23). The puncture guide needle (1) is inserted into the sheath body (3) from top to bottom, and the blunt end (11) protrudes outside the sheath body (3) and smoothly transitions with the end of the sheath body (3). 2. The device according to claim 1, characterized in that, the interior of the puncture guide needle (1) is a hollow structure with a transparent end. 3. The device according to claim 1, characterized in that, the upper part of the puncture guide needle (1) has a first annular protrusion (12) whose outer diameter is greater than the inner diameter of the sheath (3), so that the blunt round The end (11) just protrudes outside the sheath body (3), and transitions smoothly with the end of the sheath body (3). 4. The device according to claim 1, characterized in that the wall of the central circular hole (23) has a rubber ring for fixing the position of the sheath (3) in the introducer (2). 5. The device according to claim 1, characterized in that, the sheath (3) has a second annular protrusion (31), and the outer diameter of the second annular protrusion (31) is greater than the diameter of the central circular hole (23) . The sheath body part above the second annular protrusion (31) is an auxiliary sheath (32), and the second annular protrusion (31) and the sheath body part below form a main sheath (33). 6. The device according to claim 5, characterized in that, the main sheath (33) and the auxiliary sheath (32) are designed separately.