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WO2011042669A1 - Instrument for surgical treatment of carpal tunnel syndrome by means of endoscopy - Google Patents

Instrument for surgical treatment of carpal tunnel syndrome by means of endoscopy Download PDF

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Publication number
WO2011042669A1
WO2011042669A1 PCT/FR2010/052118 FR2010052118W WO2011042669A1 WO 2011042669 A1 WO2011042669 A1 WO 2011042669A1 FR 2010052118 W FR2010052118 W FR 2010052118W WO 2011042669 A1 WO2011042669 A1 WO 2011042669A1
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WO
WIPO (PCT)
Prior art keywords
surgical treatment
tube
probe
instrument
hook
Prior art date
Application number
PCT/FR2010/052118
Other languages
French (fr)
Inventor
Manuel Macara
Original Assignee
Manuel Macara
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Manuel Macara filed Critical Manuel Macara
Publication of WO2011042669A1 publication Critical patent/WO2011042669A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
    • A61B17/320036—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes adapted for use within the carpal tunnel

Definitions

  • the present invention relates to an instrument for surgical treatment by endoscopy of carpal tunnel syndrome.
  • the carpal tunnel is formed by small carpal bones, which have the shape of a gutter, which is closed forward by a ligament, the anterior carpal ligament or flexor retinaculum. In this channel pass especially the flexor tendons of the fingers and the median nerve.
  • the carpal tunnel syndrome is related to an increase in pressure in this channel, a pressure which, if it does not hinder said tendons, disturbs the conduction of the median nerve.
  • the treatment of this syndrome consists initially in a drug therapy by infiltration of corticosteroids, and if there is no progress, as in most cases, in a surgical treatment.
  • the procedure consists essentially of sectioning the anterior carpal ligament, in order to suppress the compression exerted on the median nerve.
  • an endoscope which gives an internal vision of the carpal tunnel and which is equipped with a blade that can be pulled out at will by a trigger, or an instrument comprising a cutting means arranged at the end of a probe tube secured to a handle configured to cooperate with an endoscope.
  • the passage of the endoscope, or the instrument that is adapted to it, in the carpal tunnel is previously prepared by means of dilators, then the endoscope, or said instrument, is introduced into the canal and positioned against the ligament so as to separate it from the median nerve and tendons, then the blade is extracted and the ligament is cut throughout its thickness.
  • the present invention aims to provide an instrument for surgical treatment by endoscopy of carpal tunnel syndrome to overcome the various aforementioned drawbacks.
  • the instrument for surgical treatment by endoscopy of carpal tunnel syndrome comprises a cutting means disposed at the end of a probe consisting of a tube attached to a handle configured to be able to cooperate with an endoscope, and is essentially characterized by that the distal end of said probe is closed and has a rounded profile, while said tube comprises a longitudinal cut forming a window and which has in the vicinity of said distal end, an extension in the axial direction and in the direction of said end , so as to create a hook which, because it is made in a tube, has two edges spaced apart from each other, which edges are, at their curved portion, cut to form two knives constituting said means cutting.
  • the tube is made of metal.
  • the distal end closed and having a rounded profile consists of a plug partially engaged in the tube.
  • it comprises, arranged in the window, a movable valve system designed to close the hook.
  • the distal end closed and having a rounded profile consists of a plug, part of which is engaged in the tube, said portion comprising an extension shaped to form a valve mobile adapted to close the hook, and to retract into said window under the effect of external pressure.
  • the handle which carries the probe comes from molding a plastic material.
  • FIG. 3 represents a partial schematic perspective view of a first embodiment of the same instrument.
  • FIG. 4 shows a schematic side elevational view of a portion of the first embodiment.
  • FIG. 5 shows a partial schematic perspective view of a second embodiment of the same instrument.
  • FIG. 6 shows a schematic perspective view of a portion of the second embodiment.
  • FIG. 7 shows a schematic perspective and exploded view of the instrument according to the invention as commercialized.
  • an instrument 1 for surgical treatment by endoscopy of the carpal tunnel syndrome according to the invention.
  • This instrument 1 comprises a handle 2 extended by a probe 3, each tubular so as to allow to introduce an endoscope, not shown.
  • the distal end 30 of the probe 3 is closed and is of rounded shape, which in this case is obtained by securing a cap 31 attached to the end 40 of the tube 4 which constitutes the probe 3.
  • the tube 4 comprises a longitudinal cutout 41 which forms a window 42 extending not far from its end 40.
  • This cutout 41 is extended in the axial direction towards the end edge 40 so as to create a hook 43, which, because of of it is created in a tube, has two edges 44 spaced from each other, only one of which is visible in the figure, consisting of the wall 45 of the tube 4.
  • the curved portion of each of the edges 44, c that is to say what constitutes the bottom of the hook 43, is shaped into a blade 46, so as to obtain two knives distant from each other.
  • cutout 41 also creates two fins 47, which after folding at right angles form, in the substantially middle region of the window 42, a bridge 48 which bar the latter.
  • the probe 3 is introduced engaged by incision made transversely at the wrist, and engaged in the carpal tunnel, being held by the handle 2 and being guided by means of an endoscope.
  • the probe 3 is engaged under the latter until the hook 3 exceeds it, then during the withdrawal movement, the ligament is hooked by the hook 43 and cut simultaneously by the blades. 46, so as to remove a piece of ligament that remains in the probe 3, and that can testify that the complete section of the ligament.
  • FIG. 3 it can be seen that the probe 3 is equipped with a hook closure system 43.
  • This closure system 5 also shown in FIG. 4, comprises a base 50 intended to be engaged by the window 42 and to be locked under the bridge 48, and a valve 51 movable relative to the base 50 and extending from the latter towards the free end 49 of the hook 43, against the inner edge of which bears The free end 52 of the valve 51.
  • the closure system 5 is made of a flexible material of thermoplastic type, so as to allow the retraction of the valve 51 by elastic deformation.
  • FIGS 5 and 6 show a system 6 for closing the hook 43, according to another embodiment.
  • This system 6 comprises in one piece, made of flexible thermoplastic material:
  • a movable valve 61 extending from the element 60 towards the end 49 of the hook 43, against the inner edge of which bears the free end 62 of the valve 61,
  • valve 51 or 61 allows after the section of the ligament, to close the hook 43 and maintain in the tube 4 the piece of ligament removed.
  • This version relates to a disposable instrument, disposable after use, and this instrument is therefore expected to have a reduced manufacturing cost.
  • the probe 3 is made of metal, preferably stainless steel, while the handle 2, to which the probe 3 can be secured by fitting, is molding a plastic material.
  • the handle 2 is molded simultaneously with a probe dilator 7, the two elements being connected by a breakable junction 70.

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  • Health & Medical Sciences (AREA)
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  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
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  • Surgical Instruments (AREA)

Abstract

The invention relates to an instrument for surgical treatment of carpal tunnel syndrome by means of endoscopy, including a cutting means arranged at the end of a probe (3) made up of a tube (4) secured to a handle (2) configured such as to engage with an endoscope. The distal end (30) of the probe (3) is closed and has a rounded profile, while the tube (4) comprises a longitudinal cut (41) forming a window and, next to the distal end (30), an axial extension in the direction of said end (30), such as to form a hook (43) which, being made in a tube, comprises two edges separated from one another, said edges (44) being, at the curved portion thereof, cut to form two blades that constitute the cutting means.

Description

INSTRUMENT DE TRAITEMENT CHIRURGICAL PAR ENDOSCOPIE Dû SYNDROME DU CANAL CARPIEN INSTRUMENT FOR SURGICAL TREATMENT BY ENDOSCOPY OF CARPAL CANAL SYNDROME
La présente invention a pour objet un instrument de traitement chirurgical par endoscopie du syndrome du canal carpien . The present invention relates to an instrument for surgical treatment by endoscopy of carpal tunnel syndrome.
Le canal carpien est formé par les petits osselets du carpe, qui ont la forme d'une gouttière, laquelle est fermée en avant par un ligament, le ligament annulaire antérieur du carpe ou retinaculum des fléchisseurs. Dans ce canal passent notamment les tendons fléchisseurs des doigts et le nerf médian. Le syndrome du canal carpien est lié à une augmentation de pression dans ce canal, pression qui, si elle ne constitue pas une gêne pour lesdits tendons, perturbe la conduction du nerf médian. The carpal tunnel is formed by small carpal bones, which have the shape of a gutter, which is closed forward by a ligament, the anterior carpal ligament or flexor retinaculum. In this channel pass especially the flexor tendons of the fingers and the median nerve. The carpal tunnel syndrome is related to an increase in pressure in this channel, a pressure which, if it does not hinder said tendons, disturbs the conduction of the median nerve.
Le traitement de ce syndrome consiste dans premier temps soit en une thérapie médicamenteuse par infiltration de corticoïdes, et s'il n'y a pas de progrès, comme dans la plus part des cas, en un traitement chirurgical . The treatment of this syndrome consists initially in a drug therapy by infiltration of corticosteroids, and if there is no progress, as in most cases, in a surgical treatment.
L'intervention consiste essentiellement à sectionner le ligament annulaire antérieur du carpe, afin de supprimer la compression qu ' il exerce sur le nerf médian . II existe deux méthodes, la méthode classique qui consiste à réaliser une incision cutanée longitudinale d'environ 3 cm sur le talon de la paume de la main, et la méthode endoscopique qui ne nécessite une, voire deux incisions transversales de 1 cm au poignet et l'autre, si nécessaire, dans la paume. The procedure consists essentially of sectioning the anterior carpal ligament, in order to suppress the compression exerted on the median nerve. There are two methods, the classic method of making a longitudinal skin incision of about 3 cm on the heel of the palm of the hand, and the endoscopic method that requires one or two transverse incisions of 1 cm on the wrist and the other, if necessary, in the palm.
Pour la méthode endoscopique on utilise un endoscope qui donne une vision interne du canal carpien et qui est équipé d'une lame que l'on peut faire sortir à volonté grâce à une gâchette, ou bien un instrument comprenant un moyen de coupe disposé à l'extrémité d'un tube sonde assujetti à un manche configuré pour pouvoir coopérer avec un endoscope. Le passage de l'endoscope, ou de l'instrument qui lui est adapté, dans le canal carpien est préalablement préparé au moyen de dilatateurs, puis l'endoscope, ou ledit instrument, est introduit dans le canal et positionné contre le ligament en sorte de le séparer du nerf médian et des tendons, puis la lame est extraite et le ligament est coupé sur toute son épaisseur. For the endoscopic method an endoscope is used which gives an internal vision of the carpal tunnel and which is equipped with a blade that can be pulled out at will by a trigger, or an instrument comprising a cutting means arranged at the end of a probe tube secured to a handle configured to cooperate with an endoscope. The passage of the endoscope, or the instrument that is adapted to it, in the carpal tunnel is previously prepared by means of dilators, then the endoscope, or said instrument, is introduced into the canal and positioned against the ligament so as to separate it from the median nerve and tendons, then the blade is extracted and the ligament is cut throughout its thickness.
Malgré la simplicité de cette méthode, elle n'est pas la préférée des praticiens, notamment parce que les instruments de traitement chirurgical actuellement proposés ne permettent pas d'éviter certains risques de blessure nerveuse. Despite the simplicity of this method, it is not the favorite of practitioners, especially because the currently proposed surgical treatment instruments do not prevent some risk of nerve injury.
Par ailleurs, il est reproché à cette méthode de générer des cas de récidive, plus que ceux observer pour la méthode classique. Moreover, this method is criticized for generating cases of recidivism, more than those observed for the classical method.
La présente invention a pour but de proposer un instrument de traitement chirurgical par endoscopie du syndrome du canal carpien permettant de remédier aux divers inconvénients précités . The present invention aims to provide an instrument for surgical treatment by endoscopy of carpal tunnel syndrome to overcome the various aforementioned drawbacks.
L'instrument de traitement chirurgical par endoscopie du syndrome du canal carpien comprend un moyen de coupe disposé à l'extrémité d'une sonde constituée d'un tube assujetti à un manche configuré pour pouvoir coopérer avec un endoscope, et il se caractérise essentiellement en ce que l'extrémité distale de ladite sonde est fermée et présente un profil arrondi, tandis que ledit tube comporte une découpe longitudinale formant une fenêtre et qui présente à proximité de ladite extrémité distale, un prolongement dans le sens axial et en direction de ladite extrémité, en sorte créer un crochet qui, du fait qu'il est réalisé dans un tube, comporte deux bords distants l'un de l'autre, lesquels bords sont, au niveau de leur partie courbe, taillés pour former deux couteaux constituant ledit moyen de coupe . Selon une caractéristique additionnelle de l'instrument de traitement chirurgical selon l'invention, le tube est réalisé en métal . Selon une autre caractéristique additionnelle de 1 ' instrument de traitement chirurgical selon l'invention, l'extrémité distale fermée et présentant un profil arrondi, consiste en un bouchon engagé partiellement dans le tube. Selon une autre caractéristique additionnelle de l'instrument de traitement chirurgical selon l'invention, il comporte, disposé dans la fenêtre, un système de clapet mobile conçu apte à fermer le crochet . Selon une autre caractéristique additionnelle de l'instrument de traitement chirurgical selon l'invention, l'extrémité distale fermée et présentant un profil arrondi consiste en un bouchon dont une partie est engagée dans le tube, ladite partie comprenant un prolongement conformé pour former un clapet mobile apte à fermer le crochet, et à s'escamoter dans ladite fenêtre sous l'effet d'une pression extérieure. The instrument for surgical treatment by endoscopy of carpal tunnel syndrome comprises a cutting means disposed at the end of a probe consisting of a tube attached to a handle configured to be able to cooperate with an endoscope, and is essentially characterized by that the distal end of said probe is closed and has a rounded profile, while said tube comprises a longitudinal cut forming a window and which has in the vicinity of said distal end, an extension in the axial direction and in the direction of said end , so as to create a hook which, because it is made in a tube, has two edges spaced apart from each other, which edges are, at their curved portion, cut to form two knives constituting said means cutting. According to an additional feature of the surgical treatment instrument according to the invention, the tube is made of metal. According to another additional feature of the surgical treatment instrument according to the invention, the distal end closed and having a rounded profile, consists of a plug partially engaged in the tube. According to another additional feature of the surgical treatment instrument according to the invention, it comprises, arranged in the window, a movable valve system designed to close the hook. According to another additional feature of the surgical treatment instrument according to the invention, the distal end closed and having a rounded profile consists of a plug, part of which is engaged in the tube, said portion comprising an extension shaped to form a valve mobile adapted to close the hook, and to retract into said window under the effect of external pressure.
Selon une autre caractéristique additionnelle de 1 ' instrument de traitement chirurgical selon l'invention, le manche qui porte la sonde, vient de moulage d'une matière plastique. According to another additional characteristic of the surgical treatment instrument according to the invention, the handle which carries the probe, comes from molding a plastic material.
Les avantages et les caractéristiques de l'instrument de traitement chirurgical selon l'invention, ressortiront plus clairement de la description qui suit et qui se rapporte au dessin annexé, lequel en représente un mode de réalisation non limitatif . The advantages and characteristics of the surgical treatment instrument according to the invention will become more clearly apparent from the description which follows and which refers to the appended drawing, which represents a non-limiting embodiment thereof.
Dans le dessin annexé : - la figure 1 représente une vue schématique en perspective d'un instrument de traitement chirurgical selon l'invention. - la figure 2 représente une vue schématique en perspective d'une partie du même Instrument. In the accompanying drawing: - Figure 1 shows a schematic perspective view of a surgical treatment instrument according to the invention. - Figure 2 shows a schematic perspective view of part of the same Instrument.
- la figure 3 représente une vue schématique partielle en perspective d'un premier mode de réalisation du même Instrument. FIG. 3 represents a partial schematic perspective view of a first embodiment of the same instrument.
- la figure 4 représente une vue schématique en élévation de profil d'une partie du premier mode de réalisation. - la figure 5 représente une vue schématique partielle en perspective d'un second mode de réalisation du même instrument. - Figure 4 shows a schematic side elevational view of a portion of the first embodiment. - Figure 5 shows a partial schematic perspective view of a second embodiment of the same instrument.
- la figure 6 représente une vue schématique en perspective d'une partie du second mode de réalisation. - Figure 6 shows a schematic perspective view of a portion of the second embodiment.
- la figure 7 représente une vue schématique perspective et en éclaté de l'instrument selon l'invention tel que commercialisé. - Figure 7 shows a schematic perspective and exploded view of the instrument according to the invention as commercialized.
En référence à la figure 1, on peut voir un instrument 1 de traitement chirurgical par endoscopie du syndrome du canal carpien selon 1 ' invention . With reference to FIG. 1, there can be seen an instrument 1 for surgical treatment by endoscopy of the carpal tunnel syndrome according to the invention.
Cet instrument 1 comprend un manche 2 prolongé d'une sonde 3, chacun tubulaire en sorte de permettre d'y introduire un endoscope, non représenté. This instrument 1 comprises a handle 2 extended by a probe 3, each tubular so as to allow to introduce an endoscope, not shown.
Comme on peut le voir plus précisément sur la figure 2, l'extrémité distale 30 de la sonde 3 est fermée et est de forme arrondie, ce qui en l'occurrence est obtenu par assujettissement d'un bouchon 31 fixé à l'extrémité 40 du tube 4 qui constitue la sonde 3. As can be seen more specifically in FIG. 2, the distal end 30 of the probe 3 is closed and is of rounded shape, which in this case is obtained by securing a cap 31 attached to the end 40 of the tube 4 which constitutes the probe 3.
Le tube 4 comporte une découpe longitudinale 41 qui forme une fenêtre 42 s ' étendant non loin de son extrémité 40. Cette découpe 41 est prolongée dans le sens axial en direction du bord extrême 40 en sorte de créer un crochet 43, lequel, du fait de qu'il est créé dans un tube, présente deux bords 44 distants l'un de l'autre, dont un seul est visible sur la figure, constitués de la paroi 45 du tube 4. La partie courbe de chacun des bords 44, c'est-à-dire ce qui constitue le fond du crochet 43, est conformée en une lame 46, de manière à obtenir deux couteaux distants l'un de l'autre. The tube 4 comprises a longitudinal cutout 41 which forms a window 42 extending not far from its end 40. This cutout 41 is extended in the axial direction towards the end edge 40 so as to create a hook 43, which, because of of it is created in a tube, has two edges 44 spaced from each other, only one of which is visible in the figure, consisting of the wall 45 of the tube 4. The curved portion of each of the edges 44, c that is to say what constitutes the bottom of the hook 43, is shaped into a blade 46, so as to obtain two knives distant from each other.
On notera par ailleurs que la découpe 41 crée également deux ailettes 47, qui après repliement à angle droit forment, dans la région sensiblement médiane de la fenêtre 42, un pont 48 qui barre cette dernière . Note also that the cutout 41 also creates two fins 47, which after folding at right angles form, in the substantially middle region of the window 42, a bridge 48 which bar the latter.
En pratique, la sonde 3 est introduite engagée par incision réalisée transversalement au niveau du poignet, et engagée dans le canal carpien, en étant maintenue par le manche 2 et en étant guidée au moyen d'un endoscope. Lorsque le ligament annulaire antérieur du carpe est atteint, la sonde 3 est engagée sous ce dernier jusqu'à ce que le crochet 3 le dépasse, puis lors du mouvement de retrait, le ligament est accroché par le crochet 43 et coupé simultanément par les lames 46, en sorte d'enlever un morceau de ligament qui demeure dans la sonde 3, et qui permet de témoigner que la section complète du ligament . In practice, the probe 3 is introduced engaged by incision made transversely at the wrist, and engaged in the carpal tunnel, being held by the handle 2 and being guided by means of an endoscope. When the anterior carpal ligament is reached, the probe 3 is engaged under the latter until the hook 3 exceeds it, then during the withdrawal movement, the ligament is hooked by the hook 43 and cut simultaneously by the blades. 46, so as to remove a piece of ligament that remains in the probe 3, and that can testify that the complete section of the ligament.
En référence maintenant à la figure 3, on peut voir la sonde 3 est équipée d'un système 5 de fermeture du crochet 43. Ce système de fermeture 5, représenté également à la figure 4, comprend une base 50 destinée à être engagée par la fenêtre 42 et à être bloquée sous le pont 48, et un clapet 51 mobile par rapport à la base 50 et s 'étendant depuis cette dernière en direction de l'extrémité libre 49 du crochet 43, contre le bord interne de laquelle vient en appui 1 ' extrémité libre 52 du clapet 51. Referring now to FIG. 3, it can be seen that the probe 3 is equipped with a hook closure system 43. This closure system 5, also shown in FIG. 4, comprises a base 50 intended to be engaged by the window 42 and to be locked under the bridge 48, and a valve 51 movable relative to the base 50 and extending from the latter towards the free end 49 of the hook 43, against the inner edge of which bears The free end 52 of the valve 51.
Le système de fermeture 5 est réalisé dans un matériau souple de type thermoplastique, en sorte de permettre l'escamotage du clapet 51 par déformation élastique. La mobilité du clapet 51 permet ainsi son escamotage dans la fenêtre 42 sous l'effet d'une pression extérieure, exercée par le ligament par exemple, et son retour en position de fermeture du crochet 43 lorsque cette pression est annulée. The closure system 5 is made of a flexible material of thermoplastic type, so as to allow the retraction of the valve 51 by elastic deformation. The mobility of the valve 51 and allows its retraction in the window 42 under the effect of external pressure, exerted by the ligament, for example, and its return to the closed position of the hook 43 when this pressure is canceled.
Les figures 5 et 6 représentent un système 6 de fermeture du crochet 43, selon un autre mode de réalisation. Ce système 6 comprend dans une seule pièce, réalisé en matériau souple de type thermoplastique : Figures 5 and 6 show a system 6 for closing the hook 43, according to another embodiment. This system 6 comprises in one piece, made of flexible thermoplastic material:
- un élément 60 de blocage sous le pont 48, a blocking element 60 under the bridge 48,
- un clapet mobile 61 s 'étendant depuis l'élément 60 vers l'extrémité 49 du crochet 43, contre le bord interne de laquelle vient prendre appui l'extrémité libre 62 du clapet 61, - A movable valve 61 extending from the element 60 towards the end 49 of the hook 43, against the inner edge of which bears the free end 62 of the valve 61,
- un bouchon 63 venant se substituer au bouchon 31. a stopper 63 that replaces the stopper 31.
Quel que soit le mode de réalisation, le clapet 51 ou 61 permet après la section du ligament, de refermer le crochet 43 et de maintenir dans le tube 4 le morceau de ligament prélevé . Whatever the embodiment, the valve 51 or 61 allows after the section of the ligament, to close the hook 43 and maintain in the tube 4 the piece of ligament removed.
En référence maintenant à la figure 7, on peut voir une version de l'instrument selon l'invention, tel qu'il peut se présenter avant son utilisation. Referring now to Figure 7, we can see a version of the instrument according to the invention, as it may occur before use.
Cette version est relative à un instrument à usage unique, jetable après utilisation, et cet instrument est donc prévu d'un coût de fabrication réduit . This version relates to a disposable instrument, disposable after use, and this instrument is therefore expected to have a reduced manufacturing cost.
Ainsi, la sonde 3 est réalisée en métal, de préférence en inox, tandis que le manche 2, auquel la sonde 3 peut être assujettie par emmanchement, vient de moulage d'une matière plastique. Comme on peut le voir sur cette figure, le manche 2 est moulé simultanément avec un dilatateur palpateur 7, les deux éléments étant reliés par une jonction sécable 70. Thus, the probe 3 is made of metal, preferably stainless steel, while the handle 2, to which the probe 3 can be secured by fitting, is molding a plastic material. As can be seen in this figure, the handle 2 is molded simultaneously with a probe dilator 7, the two elements being connected by a breakable junction 70.

Claims

REVENDICATIONS
1) Instrument de traitement chirurgical par endoscopie du syndrome du canal carpien, comprenant un moyen de coupe (46) disposé à l'extrémité d'une sonde (3) constituée d'un tube (4) assujetti à un manche (2) configuré pour pouvoir coopérer avec un endoscope, caractérisé en ce que l'extrémité distale (30) de ladite sonde (3) est fermée et présente un profil arrondi, tandis que ledit tube (4) comporte une découpe longitudinale (41) formant une fenêtre (42) et qui présente à proximité de ladite extrémité distale (30) , un prolongement dans le sens axial et en direction de ladite extrémité (30) , en sorte créer un crochet (43) qui, du fait qu'il est réalisé dans un tube, comporte deux bords (44) distants l'un de l'autre, lesquels bords (44) sont, au niveau de leur partie courbe, taillés pour former deux couteaux (46) constituant ledit moyen de coupe. 1) instrument for surgical treatment by endoscopy of the carpal tunnel syndrome, comprising a cutting means (46) disposed at the end of a probe (3) consisting of a tube (4) secured to a handle (2) configured to be able to cooperate with an endoscope, characterized in that the distal end (30) of said probe (3) is closed and has a rounded profile, whereas said tube (4) comprises a longitudinal cutout (41) forming a window ( 42) and having in the vicinity of said distal end (30), an extension in the axial direction and towards said end (30), so as to create a hook (43) which, because it is made in a tube, has two edges (44) spaced from one another, which edges (44) are, at their curved portion, cut to form two knives (46) constituting said cutting means.
2) Instrument de traitement chirurgical selon la revendication 1, caractérisé en ce que le tube (4) est réalisé en métal. 2) Surgical treatment instrument according to claim 1, characterized in that the tube (4) is made of metal.
3) Instrument de traitement chirurgical selon la revendication 1 ou la revendication 2, caractérisé en ce que l'extrémité distale fermée et présentant un profil arrondi, consiste en un bouchon (31) engagé partiellement dans le tube (4) . 3) Surgical treatment instrument according to claim 1 or claim 2, characterized in that the distal end closed and having a rounded profile, consists of a plug (31) partially engaged in the tube (4).
4) Instrument de traitement chirurgical selon l'une quelconque des revendications précédentes, caractérisé en ce qu'il comporte, disposé dans la fenêtre (42) , un système (5) de clapet mobile (51) conçu apte à fermer le crochet (43) , et à s'escamoter dans ladite fenêtre (42) sous l'effet d'une pression extérieure . 4) Surgical treatment instrument according to any one of the preceding claims, characterized in that it comprises, disposed in the window (42), a system (5) of movable valve (51) adapted to close the hook (43). ), and to retract into said window (42) under the effect of an external pressure.
5) Instrument de traitement chirurgical selon la revendication 1 ou la revendication 2, caractérisé en ce que l'extrémité distale fermée et présentant un profil arrondi consiste en un bouchon (63) dont une partie est engagée dans le tube, ladite partie comprenant un prolongement conformé pour former un clapet mobile (61) apte à fermer le crochet (43), et à s'escamoter dans ladite S fenêtre (42) sous l'effet d'une pression extérieure. 5) Surgical treatment instrument according to claim 1 or claim 2, characterized in that the distal end closed and having a rounded profile consists of a plug (63) of which a portion is engaged in the tube, said portion comprising an extension shaped to form a movable valve (61) adapted to close the hook (43), and to retract in said S window (42) under the effect of an external pressure.
6) Instrument de traitement chirurgical selon l'une quelconque des revendications précédentes, caractérisé en ce que le manche (2) qui porte la sonde (3), vient de moulage d'une matière0 plastique. 6) Surgical treatment instrument according to any one of the preceding claims, characterized in that the handle (2) which carries the probe (3), has just molded a plastic material.
PCT/FR2010/052118 2009-10-08 2010-10-08 Instrument for surgical treatment of carpal tunnel syndrome by means of endoscopy WO2011042669A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
FR0957009A FR2951066B1 (en) 2009-10-08 2009-10-08 INSTRUMENT FOR SURGICAL TREATMENT BY ENDOSCOPY OF CARPAL CANAL SYNDROME.
FR0957009 2009-10-08

Publications (1)

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WO2011042669A1 true WO2011042669A1 (en) 2011-04-14

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WO (1) WO2011042669A1 (en)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN108403166A (en) * 2018-03-19 2018-08-17 秦素红 The application method of nerve hook is adjusted in a kind of stable
CN108403168A (en) * 2018-03-19 2018-08-17 秦素红 A kind of application method of built-in adjustable nerve hook and nerve hook
CN108403167A (en) * 2018-03-19 2018-08-17 秦素红 A kind of operation flexible nerve hook and application method
CN108577906A (en) * 2018-03-19 2018-09-28 秦素红 A kind of flexible nerve hook of operation
CN108577905A (en) * 2018-03-19 2018-09-28 秦素红 A kind of built-in adjustable nerve hook

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EP0645120A1 (en) * 1993-09-14 1995-03-29 BERGER, J., Lee Grooved catheter director apparatus
US5569283A (en) * 1993-09-03 1996-10-29 United States Surgical Corporation Surgical cutting instrument with guarded blade
US5782850A (en) * 1994-10-12 1998-07-21 Ro; Man Tack Method for treating trigger finger, and medical instrument therefor
US5868768A (en) * 1995-06-07 1999-02-09 Baxter International Inc. Method and device for endoluminal disruption of venous valves

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5569283A (en) * 1993-09-03 1996-10-29 United States Surgical Corporation Surgical cutting instrument with guarded blade
EP0645120A1 (en) * 1993-09-14 1995-03-29 BERGER, J., Lee Grooved catheter director apparatus
US5782850A (en) * 1994-10-12 1998-07-21 Ro; Man Tack Method for treating trigger finger, and medical instrument therefor
US5868768A (en) * 1995-06-07 1999-02-09 Baxter International Inc. Method and device for endoluminal disruption of venous valves

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN108403166A (en) * 2018-03-19 2018-08-17 秦素红 The application method of nerve hook is adjusted in a kind of stable
CN108403168A (en) * 2018-03-19 2018-08-17 秦素红 A kind of application method of built-in adjustable nerve hook and nerve hook
CN108403167A (en) * 2018-03-19 2018-08-17 秦素红 A kind of operation flexible nerve hook and application method
CN108577906A (en) * 2018-03-19 2018-09-28 秦素红 A kind of flexible nerve hook of operation
CN108577905A (en) * 2018-03-19 2018-09-28 秦素红 A kind of built-in adjustable nerve hook

Also Published As

Publication number Publication date
FR2951066A1 (en) 2011-04-15
FR2951066B1 (en) 2011-12-09

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