CN113749728A

CN113749728A - Reaming tool for minimally invasive surgery

Info

Publication number: CN113749728A
Application number: CN202111123581.4A
Authority: CN
Inventors: 宋国俊
Original assignee: Individual
Current assignee: Individual
Priority date: 2021-07-20
Filing date: 2021-09-24
Publication date: 2021-12-07
Also published as: CN113857780A

Abstract

The present invention claims a reaming tool for minimally invasive surgery, comprising a tube body, a second cutting portion connected to the tube body in a lumen at the front end of the tube body, the second cutting portion having one or more radially arranged cutting portions A through hole communicating with the lumen is formed between the cutting edge, the second cutting portion and the tube body. By arranging a second cutting portion at the front end of the tube body, the second cutting portion has one or more cutting edges arranged radially, and the surgical channel can be formed at one time by the second cutting portion during the operation. A speculum is arranged in the lumen of the tube body, and through the through hole formed between the second cutting part and the tube body, the situation of the surgical drilling can be observed in real time, and visualization can be realized in the whole process of establishing the surgical channel.

Description

Reaming tool for minimally invasive surgery

Technical Field

The invention relates to the technical field of minimally invasive medical tools, in particular to a reaming tool for minimally invasive surgery.

Background

The surgical treatment of the intervertebral disc protrusion gradually develops from the common open surgical treatment with large trauma to the endoscopic minimally invasive surgical treatment with a small incision of 8mm, which is a great technical progress. The minimally invasive surgery for intervertebral disc protrusion under the endoscope with the first generation of 8mm small incision is to perform step-by-step reaming on three-stage (the sizes of the three-stage (5 mm, 6.5mm and 7.5mm respectively)) trepan (front annular saw teeth) to establish a surgery channel. The minimally invasive surgery for intervertebral disc protrusion under the second generation of 8mm small incision endoscopes is to perform gradual reaming on five-stage (the sizes are respectively 4mm, 6mm, 7mm, 8mm and 9 mm) bone drills (the front ends are blunt, and the side surfaces are spirally milled to form edges) to establish a surgery channel.

The prior art, surgical treatment of intervertebral disc protrusion, typically includes both trephine and bone drill.

The realization process of the technical mode represented by the trepan is as follows: determining the position of a needle feeding point of the body surface through perspective; the puncture needle punctures to reach the positioning point of the articular process; the guide wire reaches the positioning point through the puncture needle tube; withdrawing the puncture needle; the gradual expansion pipe enters along the guide wire to expand the muscle tissue; the trepan protection sleeve enters along the expansion pipe; the expanding pipe is withdrawn, and simultaneously the three-stage trepan enters along the protective sleeve and saws and grinds the bone from thin to thick step by step; thereby completing the establishment of the surgical tunnel.

In addition, the implementation of the technical method represented by the bone drill is as follows: determining the position of a needle feeding point of the body surface through perspective; the puncture needle punctures to reach the positioning point of the articular process; the guide wire reaches the positioning point through the puncture needle tube; withdrawing the puncture needle; the gradual expansion pipe enters along the guide wire to expand the muscle tissue; withdrawing the expansion pipe; using a special locator to enter a locating point on the articular process along the guide wire; using the positioner to create a small hole in the articular process that enters the spinal canal; withdrawing the positioner; a guidewire enters the spinal canal along a foramen created on the articular process; reaming the bone from thin to thick step by step along guide wire by using a five-step bone drill; thereby completing the establishment of the surgical tunnel.

Disadvantages in applying the trepan technique include: the trepan front end is annular sawtooth, and at the in-process that saw ground, whether the sawtooth reachs or gets into the canalis spinalis and relies on doctor's experience of feeling completely, if the sawtooth still saw ground forward after reacing the canalis spinalis, the sawtooth harms nerve root very easily, causes medical accident even, so the security is poor, and the operation risk is high. The trepan operation mode is used, the guide wire is only positioned on the surface of the articular process, and in the trepan sawing and grinding process, the operation doctor hardly controls the positioning direction accurately, so that the position of an operation channel has deviation, and the trepan grinding process needs to be repeated for position correction, so that the damage to bones can be increased, the positioning accuracy is poor, and the sawing and grinding process is operated under blind vision.

Disadvantages in applying bone drill technology include: the positioning requirement is higher, and the X-ray fluoroscopy times are more. The five-stage bone drill side milling edge gradually expands and grinds, which is time-consuming, and the bone drill has extrusion tension on the periphery and the front end in the grinding process. Because the operation is performed under the local anesthesia, the time for the patient to endure the pain is longer, and the grinding process is performed under blind vision.

Disclosure of Invention

In order to solve the technical problems in the background technology, the invention provides a reaming tool for minimally invasive surgery.

The invention provides a reaming tool for minimally invasive surgery, which comprises a tube body, wherein a first cutting part is arranged on the end surface of the front end of the tube body, and the first cutting part is provided with a plurality of cutting blades which are annularly arranged; and a second cutting part connected with the pipe body is arranged in the pipe cavity at the front end of the pipe body, the second cutting part is provided with one or more cutting blades arranged in the radial direction, and a through hole communicated with the pipe cavity is formed between the second cutting part and the pipe body.

Wherein, the cutting blade of the second cutting part forms an obtuse angle with the external included angle of the axis of the pipe body.

Wherein the plurality of cutting blades of the second cutting portion have the same cutting direction.

And the included angle formed between any two adjacent cutting blades on the second cutting part is equal.

Wherein, the second cutting part is provided with a notch for cutting off the middle part of the cutting blade.

Wherein the notch has a first plane parallel to the axis of the tube and a second plane perpendicular to the cutting edge.

Wherein, the second cutting part is provided with a guide hole which is coaxially arranged with the pipe body.

The cutting blade of the second cutting part is connected with the cutting blade of the first cutting part and is in smooth transition.

The embodiment of the invention provides a reaming tool for minimally invasive surgery, which comprises a tube body, wherein a second cutting part connected with the tube body is arranged in a tube cavity at the front end of the tube body, the second cutting part is provided with one or more cutting blades arranged in the radial direction, and a through hole communicated with the tube cavity is formed between the second cutting part and the tube body. By providing the second cutting portion at the front end of the tube body and having one or more cutting blades arranged radially, one-time forming of the operative corridor can be achieved by the second cutting portion during the operation. The endoscope is arranged in the tube cavity of the tube body, the drilling condition of the operation can be observed in real time through the through hole formed between any two adjacent second cutting parts, and the visualization of the whole process of establishing the operation channel is realized.

Drawings

Fig. 1 is a structural diagram of a reaming tool for minimally invasive surgery according to an embodiment of the present invention.

Fig. 2 is a top view of fig. 1.

Fig. 3 is a structural diagram of a reaming tool for minimally invasive surgery according to an embodiment of the invention.

Fig. 4 is a top view of fig. 3.

Fig. 5 is a sectional view taken along line a-a in fig. 4.

Fig. 6 is a structural diagram of a reaming tool for minimally invasive surgery according to an embodiment of the invention.

Detailed Description

Referring to fig. 1-5, a reaming tool for minimally invasive surgery according to an embodiment of the present invention includes a tube body 1;

the second cutting part 3 connected with the pipe body 1 is arranged in the pipe cavity at the front end of the pipe body 1, the second cutting part 3 is provided with one or more cutting blades 30 arranged in the radial direction, and a through hole communicated with the pipe cavity is formed between the second cutting part 3 and the pipe body 1.

In a further embodiment, the second cutting portion 3 is arranged such that the cutting blade 30 is at an obtuse angle with respect to the outer included angle α of the axis of the tube 1, the second cutting portion 3 forms the cutting blade 30 at the front end of the tube 1, the cutting blade 30 being arranged obliquely outward and protruding from the front end of the tube 1. By the radially arranged cutting blades 30 at the front end of the second cutting part 3, a conical cutting and drilling surface similar to a cone can be formed during rotation, and the cutting and drilling can be performed obliquely on the bone.

In a further embodiment, the front end of the second cutting part 3 has a plurality of cutting edges 30 arranged radially, the plurality of cutting edges 30 are configured to have the same cutting direction, and the cutting directions of the plurality of cutting edges 30 are all arranged towards a clockwise or counterclockwise direction. Referring to fig. 1 and 3, the plurality of cutting blades 30 at the front end of the second cutting part 3 have a clockwise cutting direction, and align the front end of the tube body 1 to a preset position of a bone in an operation process, and the plurality of cutting blades 30 rotate clockwise to form a cutting and drilling conical surface together through the clockwise rotation of the tube body 1, so that an effective and stable cutting and drilling effect can be achieved.

In a further embodiment, the front end of the second cutting part 3 has a plurality of cutting edges 30 arranged radially, any two adjacent cutting edges 30 are configured to form an included angle therebetween, and the included angles are equal in angle. Referring to fig. 1 and 2, the second cutting portion 3 is provided at the front end thereof with two cutting blades 30, and an included angle formed between the two cutting blades 30 is 180 degrees. Referring to fig. 3 and 4, the front end of the second cutting portion 3 is provided with three cutting blades 30, and the included angles formed between every two cutting blades 30 are 120 degrees.

In the structural design of the cutting edge 30, the cutting edge 30 provided with the second cutting portion 3 is surrounded by two facets and a back facet 300 therebetween, and is further arranged at the front end of the second cutting portion 3. Referring to fig. 3, the cutting blade 30 has a back facet 300 inclined in a cross section perpendicular to the diameter of the tubular body 1, and one side of the back facet is higher and the other side is lower, and the higher side forms an effective cutting edge. In the case of having a plurality of cutting blades 30, the back facet 300 on which the plurality of cutting blades 30 are disposed is inclined in a clockwise or counterclockwise direction to achieve the plurality of cutting blades 30 having the same cutting direction.

Compared with the traditional serrated cutting blade formed by two blade surfaces, the back blade surface 300 is arranged, so that the strength of the cutting blade 30 can be greatly enhanced, and the safety of cutting and drilling is improved; and the inward and outward deformation and deformation of the cutting blade 30 after bearing the radial cutting force can be effectively prevented, so that the service life of the cutting blade 30 is prolonged.

In the above embodiment, the second cutting part 3 connected to the pipe body 1 is provided in the lumen of the front end of the pipe body 1, the front end of the second cutting part 3 is provided with one or more cutting blades 30 arranged radially, and the specific number of the cutting blades 30 and the specific structure of the second cutting part 3 can be configured according to the actual application requirements.

Regarding the number configuration of the cutting blades 30 at the leading end of the second cutting part 3, the second cutting part 3 may be configured to have one cutting blade 30 arranged radially, or, referring to fig. 1 and 2, the second cutting part 3 may be configured to have two cutting blades 30 arranged radially, or, referring to fig. 3 and 4, the second cutting part 3 may be configured to have three cutting blades 30 arranged radially; and so on.

Based on the fact that the front end of the second cutting portion 3 has one or more cutting blades 30 arranged radially, in order to meet the requirement of supporting the cutting blades 30, the second cutting portion 3 may be provided with a strip-shaped structure arranged radially, or, on the basis of the strip-shaped structure, may further extend towards the middle of the pipe body 1 to form a plate-shaped structure.

Referring to fig. 5, by providing the second cutting portion 3 as a strip-shaped structure arranged radially, it is particularly necessary to provide a plurality of strip-shaped structures and connect them at the front end of the pipe body 1 to form a whole to effectively and reliably support the cutting blade 30. By providing the second cutting portion 3 as a radially arranged plate-like structure which is arranged in the pipe body 1 along the axial direction of the pipe body 1, the second cutting portion 3 has a predetermined dimension in the axial direction of the pipe body 1, an effect of effectively and stably supporting the cutting blade 30 can be achieved, and the second cutting portion 3 can be provided as a plate-like structure or a plurality of plate-like structures. In the case of having a plurality of plate-like structures, the plurality of plate-like structures may be connected integrally in the pipe body 1, or relatively independently in the pipe body 1 without being connected. Whichever configuration of the second cutting portion 3 is selected, it is preferable that a plurality of strip-shaped structures or plate-shaped structures of the second cutting portion 3 are uniformly arranged at the front end of the tube body 1.

In the process of providing the cutting blades 30, in the case of the second cutting part 3 having a plurality of strip-shaped structures or plate-shaped structures, it is possible to select to provide one radially arranged cutting blade at the front end of one of the strip-shaped structures or plate-shaped structures, or to provide a plurality of cutting blades 30 at the front end of a part of the second cutting part 3, or to provide the cutting blades 30 at the front ends of a plurality of the second cutting parts 3. In the case of having one plate-like structure, it may be arranged that one cutting blade 30 is provided at the leading end of the second cutting portion 3 of one plate-like structure.

According to the two setting forms of the second cutting part 3, the second cutting part 3 can be configured into a fan-shaped structure according to the actual application requirement, or further extends towards the middle part of the tube body 1 on the basis of the fan-shaped structure, or; the pipe body is configured into a trapezoidal structure, or further extends towards the middle part of the pipe body 1 on the basis of the trapezoidal structure; or, configured as a heterosexual structure; and so on. The fan-shaped structure, the trapezoid structure and the extension structure thereof have better structural stability and support reliability.

As for the through holes communicating with the lumen formed between the second cutting portions 3 and the tube body 1, by arranging the second cutting portions 3 to have a plurality of strip-like structures or plate-like structures, then, through holes communicating with the lumen can be formed between the second cutting portions 3 of any two adjacent strip-like or plate-like structures and the tube body 1, thereby forming a plurality of through holes. According to the structural arrangement of the cutting blades, a plurality of cutting blades 30 are arranged at the front end of the second cutting part 3, and then any two adjacent cutting blades 30 also have the through hole therebetween.

In the operation process, a sight glass is arranged in the cavity of the tube body 1, and the drilling condition of the operation can be observed in real time through a plurality of through holes formed between the second cutting part 3 and the tube body 1.

In a further embodiment, with reference to fig. 2 and 4, the second cutting portion 3 is provided with at least one cut intercepting the middle of the cutting blade 30. The slit has a first plane parallel to the axis of the tube and a second plane perpendicular to the cutting edge.

In a further embodiment, with reference to fig. 2 and 4, a guide hole 5 is provided in the middle of the second cutting portion 2, coaxially arranged with the tubular body 1. The second cutting part 2 may be provided in a plurality of strip-shaped structures or plate-shaped structures, which may be connected to form a whole at the middle of the pipe body 1, and further, a guide hole 4 may be formed at the connection position coaxially with the pipe body 1, or a guide block may be provided at the connection position and a guide hole 5 may be formed at the guide block.

In the operation process, the guide hole 4 which is coaxial with the tube body 1 is arranged in the middle of the second cutting part 2, the guide hole 5 is used as a through hole of the operation guide wire, the operation guide wire passes through the guide hole 5, the positioning is simple, the positioning direction is not deviated, and the accurate control of the operation position can be realized.

According to the technical scheme of the embodiment, the end face of the front end of the pipe body 1 is provided with a first cutting part 2, and the first cutting part 2 is provided with a plurality of cutting blades 20 which are annularly arranged; the cutting blade 20 of the first cutting portion 2 is disposed at the end surface of the front end of the tube body 1, and the cutting blade 30 of the second cutting portion 3 is disposed to be inclined outward through the front end of the tube body 1 and protruded from the front end of the tube body 1, so that the cutting blade 30 of the second cutting portion 3 is protruded from the cutting blade 20 of the first cutting portion 2. During the operation, the cutting blade 30 of the second cutting part 3 first acts on the bone to start drilling, and after drilling to a predetermined depth, the cutting blade 20 of the first cutting part 2 acts on the bone to further enlarge the outer diameter of the drilled hole.

Referring to fig. 1 and 3, the plurality of cutting blades 20 of the first cutting part 2 have the same cutting direction and are the same as the cutting direction of the plurality of cutting blades 30 of the second cutting part 3. In a further embodiment, the plurality of cutting edges 20 of the first cutting portion 2 provide a back facet which, viewed in the Z-direction in fig. 4, is obliquely arranged with one side higher and the other lower, the higher side forming the effective cutting edge; the back facet of each of the plurality of cutting blades 20 is inclined in a clockwise or counterclockwise direction. In a further embodiment, the plurality of cutting blades 20 of the first cutting portion 2 are higher near the inner wall of the tube 1 and lower near the outer wall of the tube 1, and the cutting blades 20 having an inclined structure with a higher inside and a lower outside are formed on the first cutting portion 2.

According to the above described embodiment, the cutting edges of the second cutting portion 3 and the cutting edges of the first cutting portion 2 are arranged to connect and smoothly transition. Referring to fig. 1 and 3, a first cutting part 2 is provided at an end surface of a front end of a tube body 1, the first cutting part 2 has twelve cutting blades 20 arranged in a ring shape, a second cutting part 3 connected to the tube body 1 is provided in a lumen of the front end of the tube body 1, and the second cutting part 3 has three cutting blades 30 arranged in a radial direction. The three cutting blades 30 of the second cutting portion 3 are connected with and smoothly transited to the three cutting blades 20 of the first cutting portion 2, and it can be understood that the cutting blades 30 of the second cutting portion 3 are formed by radially extending the cutting blades 20 of the first cutting portion 2 in the axial direction of the pipe body 1.

Referring to fig. 6, a gap may also be provided between any two second cutting portions for better manipulation and visualization during surgery. The shape of the notch can be square, arc, or other smooth curve structure.

In the embodiment of the invention, the problem that the bone drill or trepan for minimally invasive operation of intervertebral disc herniation needs to grind and expand the bone for multiple times step by step under the existing endoscope is solved, intervertebral foramen shaping can be completed at one time, and the intervertebral foramen can reach one area of the operation. The problem that the existing endoscopic minimally invasive operation trephine for herniated intervertebral disc cannot be accurately guided by a guide wire is solved, and the direction accuracy is improved. The problem of intervertebral disc protrusion minimal access surgery bone drill and trepan can not be completely visual under current scope is solved, through setting up the second cutting portion, its cutting blade of radially arranging can cut simultaneously and smash the sclerotin, the work area of clear visible instrument front end under the endoscope, at the rotatory grinding in-process of instrument, from articular process to anatomical structure level such as yellow ligament clearly visible, thoroughly solved bone drill or trepan because invisible and the operation risk that leads to in intervertebral foramen shaping process, the security of the security and the security of operation of apparatus have greatly been improved. Generally, the drilling tool for minimally invasive surgery provided by the embodiment of the invention has the characteristics of safety, accuracy, visibility and one-step forming, and is beneficial to realizing the manual intelligent endoscopic surgery in the future.

The above description is only for the preferred embodiment of the present invention, but the scope of the present invention is not limited thereto, and any person skilled in the art should be considered to be within the technical scope of the present invention, and the technical solutions and the inventive concepts thereof according to the present invention should be equivalent or changed within the scope of the present invention.

Claims

1. A reaming tool for minimally invasive surgery, comprising a pipe body (1), a first cutting portion (2) on the end face of the front end of the pipe body (1), the first cutting portion (2) having a plurality of annularly arranged The cutting edge (20) is characterized in that there is a second cutting portion (3) connected with the pipe body (1) in the lumen at the front end of the pipe body (1), the second cutting portion (3) having radially arranged One or more cutting edges (30), a through hole (4) communicating with the lumen is formed between the second cutting part (3) and the tube body (1).

2 . The reaming tool for minimally invasive surgery according to claim 1 , wherein the cutting edge ( 30 ) of the second cutting portion ( 3 ) forms an obtuse angle with the outer included angle of the axis of the tube body ( 1 ). 3 .

3. The reaming tool for minimally invasive surgery according to claim 1, characterized in that the plurality of cutting edges (30) of the second cutting portion (3) have the same cutting direction.

4 . The hole reaming tool for minimally invasive surgery according to claim 1 , wherein the angle formed between any two adjacent cutting edges ( 30 ) on the second cutting portion ( 3 ) is equal. 5 .

5. The reaming tool for minimally invasive surgery according to claim 1, characterized in that, the second cutting portion (3) is provided with an incision (31) for cutting off the middle of the cutting edge (30).

6 . The hole reaming tool for minimally invasive surgery according to claim 1 , wherein a guide hole ( 5 ) coaxially arranged with the tube body ( 1 ) is formed on the second cutting portion ( 3 ). 7 .

7. The reaming tool for minimally invasive surgery according to claims 1-6, characterized in that the cutting edge (30) of the second cutting part (3) and the cutting edge (20) of the first cutting part (2) Connect and transition smoothly.