Disclosure of Invention
The application provides a guide device and a surgical system, which solve the problems of inconvenient guide needle implantation operation, low implantation direction precision and difficult direction adjustment in the prior art.
The first aspect of the application provides a guiding device comprising a supporting arm, a guiding component and a guiding tool, wherein the supporting arm comprises a fixed end and a movable end, the guiding component comprises a connecting rod, a clamp holder and a sleeve, the connecting rod is connected with the movable end, the first end of the clamp holder is connected with the connecting rod, the second end of the clamp holder is used for clamping the sleeve, the clamp holder is in a locking state and an unlocking state, the sleeve is fixed relative to the connecting rod in the locking state, the sleeve can be adjusted in direction relative to the connecting rod in the unlocking state, the guiding tool comprises a guide cylinder and a tracer which is in a preset position relation with the guide cylinder, the guide cylinder is used for being inserted into the sleeve, and the tracer is used for determining the positions and the axial directions of the guide cylinder and the sleeve.
Based on the above embodiment, in a first alternative implementation, the holder includes a hoop, a locking shaft, a sleeve, and a locking handle, and the locking shaft sequentially passes through the locking handle, the hoop, and the sleeve.
Based on the above embodiment, in a second alternative implementation manner, the locking handle is used for switching a locking state and an unlocking state, in the unlocking state, the hoop can move or rotate relative to the connecting rod, the shaft sleeve can rotate relative to the locking part, the sleeve can move or rotate relative to the clamping hole, and in the locking state, the sleeve is fixed relative to the connecting rod.
Based on the above-mentioned embodiment, in a third alternative implementation mode, the anchor ear is sleeved on the connecting rod and the anchor ear has the locking portion of adjustable enclasping degree, one end and the locking handle of locking axle are connected, and the other end is provided with spacing portion, has seted up the centre gripping hole along the direction of perpendicular to locking axle on the axle sleeve, and spacing portion and centre gripping hole are relative effect in order to fix the sleeve under the locking state.
In a fourth alternative implementation, based on the above-mentioned embodiment, the contact surface of the locking portion and the sleeve is provided with mutually engageable protrusions for circumferential fixation when the locking portion and the sleeve are compressed.
Based on the above embodiment, in a fifth alternative implementation manner, the sleeve includes a clamping handle and a cylinder, and the length direction of the clamping handle intersects with the axial direction of the cylinder, and in the locked state, the clamping handle is inserted into the clamping hole.
Based on the above embodiment, in a sixth alternative implementation manner, one end of the connecting rod is provided with a connecting seat, the connecting seat is connected with the movable end of the supporting arm through a bolt, the movable end is provided with a positioning column, a positioning hole for plugging the positioning column is formed in the connecting seat, and the positioning column and the positioning hole are used for enabling the connecting rod to be circumferentially positioned when being connected with the movable end.
In a seventh alternative implementation, based on the above embodiment, the support arm includes a plurality of rotatable joints, and the support arm further includes a locking switch for controlling locking of each joint of the support arm to enable the support arm to form a fixed posture to support the guide assembly.
Based on the above embodiment, in an eighth alternative implementation manner, the outer circumference of the guide cylinder is matched with the inner wall of the sleeve, and a through hole is axially arranged in the guide cylinder and used for guiding the direction of the guide needle.
In a ninth alternative implementation, based on the above-mentioned embodiments, the orientation tool is provided with a movable coupling for fixedly connecting the orientation tool with the sleeve in the first state.
In a tenth alternative implementation, based on the above embodiments, the number of grippers is a plurality.
A second aspect of the application proposes a surgical system comprising a guiding device as in the first aspect, further comprising positioning means for obtaining the position of the tracer.
Advantageous effects
The guide device and the operation system provided by the application can assist in positioning guide needle implantation in orthopedic clinical operation through the arrangement of the support arm, the guide component and the orientation tool. The support arm provides a firm support for the overall guide. The guide assembly provides guide pin implantation guidance with adjustable direction, the clamp holder is provided with a locking state and an unlocking state, the sleeve is fixed relative to the connecting rod in the locking state, the sleeve can be adjusted relative to the connecting rod in the unlocking state, the sleeve with flexibly adjusted direction is connected with the orientation tool, and the guide pin implantation guidance device is combined with the guide pin implantation guidance device to provide accurate direction positioning for the guide pin, so that a doctor is assisted in performing accurate operation and is convenient to operate.
Detailed Description
Features and exemplary embodiments of various aspects of the present application will be described in detail below, and in order to make the objects, technical solutions and advantages of the present application more apparent, the present application will be described in further detail below with reference to the accompanying drawings and the detailed embodiments. It should be understood that the particular embodiments described herein are meant to be illustrative of the application only and not limiting. It will be apparent to one skilled in the art that the present application may be practiced without some of these specific details. The following description of the embodiments is merely intended to provide a better understanding of the application by showing examples of the application.
In orthopedic surgery, a guide needle (such as a k-wire) can help a doctor determine the subsequent screw placement direction or complete other direction guidance, for example, in spinal screw placement surgery, the implantation of a subsequent screw can be guided by the k-wire with the correct implantation direction. Too large deviation of the implantation direction of the guide pin can cause iatrogenic injury to a patient or greatly affect the operation effect, and even cause operation failure in serious cases.
The applicant finds that at present, clinicians often adopt a traditional method to ensure the implantation direction of the guide needle, one method is that the guide needle is implanted by a doctor according to hand feeling and experience, the other method is that the X-ray film is shot on the inserted guide needle to judge the correctness of the direction and the position of the guide needle, and the implementation and judgment of a spinal surgeon with abundant experience are needed, so that the operation is complicated. The control precision of the implantation direction and the implantation position of the two guide pins is not high, and the control precision depends on the experience of doctors to a certain extent. Therefore, to solve the above problems, a guide device is provided that can conveniently guide the implantation of a guide pin, has an accurate implantation direction, and can flexibly adjust the guiding direction.
It should be noted that, without conflict, the embodiments of the present application and features of the embodiments may be combined with each other. The embodiments will be described in detail below with reference to the accompanying drawings.
As shown in fig. 1, fig. 1 is a schematic view of the entire structure of the guide device. The guide device comprises a support arm 1, a guide assembly 2 and a directional tool 3, wherein the support arm 1 comprises a fixed end 101 and a movable end 102, the guide assembly 2 comprises a connecting rod 201, a clamp holder 202 and a sleeve 203, the connecting rod 201 is connected with the movable end 102, the first end of the clamp holder 202 is connected with the connecting rod 201, the second end of the clamp holder 202 is used for clamping the sleeve 203, the clamp holder 202 is in a locking state and an unlocking state, the sleeve 203 is fixed relative to the connecting rod 201 in the locking state, the direction of the sleeve can be adjusted relative to the connecting rod in the unlocking state, the directional tool 3 comprises a guide cylinder 301 and a tracer 302 with a preset position relation with the guide cylinder 301, the guide cylinder 301 is used for being inserted into the sleeve 203, and the tracer 302 is used for determining the positions and the axial directions of the guide cylinder 301 and the sleeve 203.
It will be readily appreciated that the support arm 1 provides a firm support for the overall guide, the support arm 1 comprising a fixed end 102 and a movable end 101. The fixing end 102 needs to be fixed in the operation space, for example, the fixing end 102 can be fixed on a side rail of the operation table by being connected with a side rail clamp, and the side rail clamp are both mature prior art, so that no description is repeated here. Of course, the fixed end of the support arm 1 may also be fixed in the operation space by means of screw connection, clamping connection, riveting, etc., which is not particularly limited herein.
In some alternative embodiments, the support arm 1 comprises a plurality of rotatable joints, the support arm further comprising a locking switch 103, the locking switch 103 being used to control the locking of the joints of the support arm 1 to enable the support arm 1 to take a fixed posture to support the guide assembly. Referring specifically to fig. 1 and 4, the support arm 1 includes three support rods and two sets of rotational joints connected between the three support rods, and the rotational joints may be spherical joints or other joints capable of ensuring the relative movement of the support rods, which is not particularly limited herein. The locking switch 103 is a knob, the locking of each joint can be realized by controlling the knob, the technology of locking each joint by the locking switch 103 is the prior art, and the principle is not repeated.
In other alternative embodiments, the support arm 1 may also be a mechanical arm capable of actively adjusting the attitude. The support arm 1 may also be a conventional bar frame composed of a plurality of links, and the relative positional relationship between the links may be individually adjusted.
The guiding component 2 provides guiding needle implantation guidance with adjustable direction, wherein the clamp 202 has a locking state and an unlocking state, the sleeve 203 is fixed relative to the connecting rod 201 in the locking state, the sleeve 203 can be adjusted relative to the connecting rod 201 in the unlocking state, the sleeve 203 with flexibly adjusted direction is connected with the orientation tool 3, accurate direction positioning is provided for the guiding needle, and the accurate operation is assisted by doctors and the operation is convenient.
As shown in fig. 2,3, 5 and 6, fig. 2 is a schematic structural view of the guide assembly and the directional tool, fig. 3 is a schematic structural view of the guide assembly, fig. 5 is a schematic structural view of the holder, and fig. 6 is a schematic sectional structural view of the holder. The guide assembly 2 comprises a connecting rod 201, a holder 202 and a sleeve 203. The gripper 202 comprises a hoop 2021, a locking shaft 2022, a shaft sleeve 2023 and a locking handle 2024, wherein the locking shaft 2022 sequentially penetrates through the locking handle 2024, the hoop 2021 and the shaft sleeve 2023.
In an alternative embodiment, the anchor ear 2021 is sleeved on the connecting rod 201, the anchor ear 2021 has a locking portion 2027 capable of adjusting the clasping degree, one end of the locking shaft 2022 is connected with the locking handle 2024, the other end of the locking shaft is provided with a limiting portion 2025, the shaft sleeve 2023 is provided with a clamping hole 2026 along the direction perpendicular to the locking shaft, and the limiting portion 2025 and the clamping hole 2026 act relatively to fix the sleeve 203 in the locked state.
With continued reference to fig. 5 and 6, the anchor 2021 may be an annular structure with an opening, and the opening of the annular structure extends out to form opposite locking portions 2027, and a gap is formed between the locking portions 2027. One end of the lock shaft 2022 is screwed with the lock handle 2024, and the other end sequentially passes through the lock portion 2027 and the sleeve 2023. The sleeve 2023 has a hollow cup shape, one end of which is close to the lock 2027, and the other end of which is provided with a through-hole 2026 along a direction perpendicular to the lock shaft 2022. The end of the locking shaft 2022 near the clamping hole 2026 is provided with a limiting portion 2025, and the limiting portion 2025 may be a hole formed in the locking shaft 2022 or a step capable of limiting axially. When the sleeve 203 needs to be clamped, that is, when the locking state of the clamp 202 is switched, the sleeve 203 is inserted into the clamping hole 2026 and passes through the limiting portion 2025, the locking handle 2024 is rotated in the first direction, the locking shaft 2022 moves axially relative to the locking handle 2024, and the limiting portion 2025 and the opposite two opposite surfaces of the clamping hole 2026 are pulled to form clamping fixation to the sleeve 203. Similarly, when the sleeve 203 needs to be released, that is, when the lock handle 2024 needs to be switched to the unlock state of the clamper 202, the lock handle 2024 may be turned in a second direction opposite to the first direction.
It is easy to understand that the locking handle 2024 is used to switch between a locked state and an unlocked state of the clamp 202, in which the anchor ear 2021 can move or rotate relative to the connecting rod 201, the sleeve 2023 can rotate relative to the locking portion 2027, the sleeve 203 can move or rotate relative to the clamping hole 2026, and in which the sleeve 203 is fixed relative to the connecting rod 201. That is, in the unlocked state, the sleeve 203 for the guide pin may be adjusted in directions and positions with multiple degrees of freedom, facilitating the physician to adjust the proper guide pin implantation direction and position as desired. When the position and direction of the sleeve 203 need to be fixed, only the locking handle 2024 needs to be turned to fix the movements of multiple degrees of freedom. The position and the direction of the sleeve 203 can be flexibly adjusted to provide guidance for the subsequent implantation of the guide pin, and the quick operation of doctors is convenient.
In some alternative embodiments, the contact surface of the locking portion 2027 and the sleeve 2023 is provided with interengageable protrusions for circumferential securement when the locking portion 2027 and sleeve 2023 are compressed. Specifically, the protrusions of the contact surface between the locking portion 2027 and the sleeve 2023 are annularly distributed, so that once the direction of the sleeve 203 is determined when the sleeve 203 is fixed in the clamping hole 2026, the engagement between the locking portion 2027 and the contact surface between the locking portion 2027 and the sleeve 2023 ensures the circumferential positioning of the locking portion 2027 and the sleeve 2023, so that the sleeve 203 cannot rotate in the guide process to change the positioning direction of the sleeve 203.
In some alternative embodiments, the sleeve 203 comprises a grip handle 2031 and a cylinder 2032, the length of the grip handle 2031 intersecting the axial direction of the cylinder 2032, and in the locked state, the grip handle 2031 is inserted into the grip hole 2026. For example, the direction of the clamping handle 2031 is perpendicular to the direction of the cylinder 2032 and has a certain length, as shown in fig. 2, so that the degree of freedom of adjusting the position of the sleeve 203 along the direction of the clamping handle 2031 is increased when the sleeve 203 is clamped through the clamping hole 2026, and the problem of oversized clamp 202 caused by directly clamping the sleeve 203 is avoided. Further, the sleeve 203 can be prevented from being deformed by the clamping without directly clamping the sleeve 203, and the accuracy of the guiding can be further ensured.
In some alternative embodiments, one end of the connecting rod 201 is provided with a connecting seat 2011, the connecting seat 2011 is connected with the movable end 101 of the supporting arm 1 through a bolt, the movable end 101 is provided with a positioning column 1011, the connecting seat 2011 is provided with a positioning hole 2012 for plugging the positioning column 1011, and the positioning column 1011 and the positioning hole 2012 are used for enabling circumferential positioning when the connecting rod 201 is connected with the movable end 101. As particularly shown in fig. 3 and 4. The connecting seat 2011 is plate-shaped, a threaded hole is formed in the middle of the connecting seat 2011, and two positioning holes 2012 are symmetrically formed in two sides of the threaded hole. The movable end of the support arm is provided with a bolt and a positioning column 1011 corresponding to the two positioning holes.
As shown in fig. 7, fig. 7 is a schematic structural view of an orientation tool, and the orientation tool 3 includes a guide cylinder 301 and a tracer 302 having a predetermined positional relationship with the guide cylinder 301, the guide cylinder 301 being for insertion into the sleeve 203, the tracer being for determining the positions and axial directions of the guide cylinder 301 and the sleeve 203. The orientation tool 3 is further provided with a handle 303 for holding the orientation tool. The periphery of the guide cylinder 301 is matched with the inner wall of the sleeve 203, and a through hole is axially formed in the guide cylinder 301 and used for guiding the guide needle direction. When the guide cylinder 301 is inserted into the sleeve 203 by the handle 303 of the handheld orientation tool, on one hand, the position and the direction of the sleeve 203 can be adjusted by inserting the handheld orientation tool 3 into the sleeve 203 before the sleeve 203 is fixed, so that the problem that the affected part is small in space and difficult to directly hold the sleeve 203 for direction and position adjustment is solved, on the other hand, after the position and the direction of the sleeve 203 are fixed, the guide cylinder 301 is inserted into the sleeve 203, the guide needle is guided by utilizing the through holes in the guide cylinder 301, and the guide of guide needles or other parts with different sizes can be met by changing the orientation tools with different through holes, so that the guide cylinder is high in universality and convenient for doctors to use.
If the direction of the implanted guide pin is not ideal, the guide device can also be used for adjusting, and the specific steps are that the clamp 202 is unlocked, the direction and the position of the sleeve 203 can be adjusted, the guide pin is placed in the ideal direction by utilizing the flexibility of the guide pin, the sleeve 203 is sleeved on the guide pin to be consistent with the ideal direction, the clamp 202 is locked, the direction of the sleeve 203 is the ideal direction for guiding the guide pin to be implanted, and finally the guide pin which is implanted in the prior guide pin is taken out and is implanted in the guide pin according to the new ideal direction.
In some alternative embodiments, the orientation tool 3 is provided with a movable coupling for fixedly connecting the orientation tool 3 with the sleeve 203 in the first state. For example, the coupling portion is an elastic contact disposed between the guide tube 301 and the sleeve 203 and circumferentially distributed, and specifically, the elastic contact is composed of a spring and a ball, and the ball has a radial moving space. The elastic contact is disposed on the sleeve 203 or the guide cylinder 301, and one of the opposite elastic contacts, which is not disposed, is provided with a space for accommodating the elastic contact, which may be an annular groove, for example. Thus, when the guide cylinder 301 is inserted into the sleeve 203, the guide cylinder 301 and the sleeve 203 can be relatively fixed, so that the position and the direction of the guide cylinder 301 can be conveniently adjusted, and one hand can be released when the guide needle is implanted after the guide cylinder is relatively fixed.
In some alternative embodiments, the number of grippers 202 is a plurality. With continued reference to FIG. 1, two grippers 202 are shown. Therefore, the device can adapt to the situation of two guide pins, and can also have relative angle references when the two guide pins are implanted, so that the guide pins are implanted more accurately. Of course, in alternative embodiments, the gripper 202 may be three, four, or more, without limitation.
The application also proposes a surgical system comprising the guiding means of the previous embodiments, and further comprising positioning means for obtaining the position of the tracer 302. Thus, when the guiding device is used for operation, the positioning device can obtain the position information of the sleeve and the orientation tool, so that the position and the direction of the implanted guide needle can be conveniently and accurately determined.
In describing embodiments of the present application, it should be understood that the terms "first," "second," and "second" are used for descriptive purposes only and are not to be construed as indicating or implying a relative importance or number of features indicated. Thus, a feature defining "a first" or "a second" may explicitly or implicitly include at least one such feature. In the description of the embodiments of the present application, the meaning of "plurality" is at least two, for example, two, three, etc., unless explicitly defined otherwise.
It should be noted that in the embodiments of the present application, relational terms such as first and second, and the like are used solely to distinguish one entity or action from another entity or action without necessarily requiring or implying any actual such relationship or order between such entities or actions. Moreover, the terms "comprises," "comprising," or any other variation thereof, are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements does not include only those elements but may include other elements not expressly listed or inherent to such process, method, article, or apparatus. Without further limitation, an element defined by the phrase "comprising" does not exclude the presence of additional identical elements in a process, method, article, or apparatus that comprises the element.
In describing embodiments of the present application, it should be understood that the terms "center", "longitudinal", "lateral", "length", "width", "thickness", "upper", "lower", "front", "rear", "left", "right", "vertical", "horizontal", "top", "bottom", "inner", "outer", "clockwise", "counterclockwise", "axial", "radial", "circumferential", etc. indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings are merely for convenience in describing the present application and simplifying the description, and do not indicate or imply that the device or element being referred to must have a specific orientation, be configured and operated in a specific orientation, and therefore should not be construed as limiting the present application.
In the embodiments of the present application, unless explicitly specified and limited otherwise, the terms "mounted," "connected," "secured" and the like are to be construed broadly, and may be, for example, fixedly connected, detachably connected or integrally formed, mechanically connected, electrically connected, directly connected, indirectly connected through an intermediate medium, in communication with each other or in an interaction relationship between two elements, unless explicitly specified otherwise. The specific meaning of the above terms in the present application can be understood by those of ordinary skill in the art according to the specific circumstances.
It will be understood that when a layer, an area, or a structure is described as being "on" or "over" another layer, another area, it can be referred to as being directly on the other layer, another area, or another layer or area can be included between the layer and the other layer, another area. And if the component is turned over, that layer, one region, will be "under" or "beneath" the other layer, another region.
It should be understood that the term "and/or" used in the embodiments of the present application is merely an association relationship describing the association object, and indicates that three relationships may exist, for example, a and/or B, and may indicate that a exists alone, while a and B exist together, and B exists alone. In addition, the character "/" in the embodiment of the present application generally indicates that the front and rear association objects are in an or relationship.
In the description of embodiments of the present application, a description of reference to the terms "one embodiment," "some embodiments," "examples," "particular examples," or "some examples," etc., means that a particular feature, structure, material, or characteristic described in connection with the embodiment or example is included in at least one embodiment or example of the present application. In describing embodiments of the present application, the schematic representations of the above terms are not necessarily directed to the same embodiment or example. Furthermore, the particular features, structures, materials, or characteristics described may be combined in any suitable manner in any one or more embodiments or examples. Furthermore, the different embodiments or examples described in this specification and the features of the different embodiments or examples may be combined and combined by those skilled in the art without contradiction.
While the application has been described in detail in the general context and with reference to specific embodiments thereof, it will be apparent to one skilled in the art that modifications and improvements can be made thereto based upon the application. Accordingly, such modifications or improvements may be made without departing from the spirit of the application and are intended to be within the scope of the application as claimed.