KR102213045B1 - Tubular Retractor for Minimally Invasive Surgery - Google Patents

Abstract

The present invention relates to a tubular retractor for microinvasive surgery implemented to insert surgical instruments into the body in a minimally invasive manner, and is inserted into a patient's body through a micro-resected space and requires surgery through the internal space. An insertion tube forming a round tube shape with one side open by bending inwardly until both wing portions face each other at predetermined intervals so that surgical equipment can be inserted to the affected area; And a nerve support that extends in a longitudinal direction from an end of the other side opposite to one side of the insertion tube so as to prevent the nerve from approaching the affected area during surgery to support the nerve to the outer surface.

Description

Tubular Retractor for Minimally Invasive Surgery}

The present invention relates to a tubular retractor for microinvasive surgery, and more specifically, microinvasive surgery implemented to insert the retractor into a small operating window in a minimally invasive manner, and then insert the surgical instrument into the affected area in need of surgery. It relates to a dragon tubular retractor.

In order to minimize the degree of damage to the body tissues, surgery is generally performed while viewing the surgical site with an endoscope or a surgical microscope. To do this, after making a small operating window, a cylindrical dilator and a traction device are used to gradually expand the inner surgical site.

For example, degenerative spinal diseases such as disc degenerative diseases (DDD), spinal stenosis, and spondylolisthesis require surgical treatment if there is no improvement in conservative treatment. , In the surgical treatment, first decompression is performed, then bone union (fusion, ALIF, PLIF, or posterolateral fusion) is performed, and after the bone union is terminated, a fixation to fix the spine is performed.

In this case, in some cases of the surgical procedure, only decompression or bone fusion is performed, but in most cases, fixation is performed.

On the other hand, the general surgical method of fixing the spine is to make an incision about 7 to 13 cm in the midline of the back, and then detach from the center of the back muscle to both sides around the spinous process. Towing.

In this case, the detachment is pulled by detaching so that the outer portion of the posterior joint is exposed.

Then, after the detachment, a fixation member of a spinal fixation device (sometimes referred to as a'spine screw') including a screw commonly referred to as a pedicle screw is inserted to perform spinal fixation by finding the entrance to the pedicle. do.

Until now, such surgery requires a large operating window for easy surgery, so in order to use a spinal fixation device, the patient's back is incised at least 10 to 15 cm, and the back muscle, which is important for maintaining the spine, is cut or damaged. After surgery, the patient's recovery is slow and there are problems such as suffering from pain.

Recently, in order to solve the above problems, a minimally invasive surgical method capable of performing spinal surgery with a small operating window has been applied to spinal surgery.

Here, the minimally invasive surgical method refers to a surgical method using an endoscope, and a fixing member of at least two spinal fixation devices by using a navigation system through the wound after making a small wound on the surgical site After fixing the spine to the spine, a surgical method of connecting each of the fixing members with a special instrument, or inserting a cylindrical expander whose diameter gradually increases in the wound area, and then pulling the muscle to the area where the cylindrical expander is inserted. By inserting a traction device to traction the muscles, the field of view is secured, and in a state where the field of view is secured, use an endoscope or microscope to find the position of the pedicle into which the fixation member of the spine fixation device will be inserted, and then fix the spine fixation device to the spine. It means the method of surgery to let.

However, in the case of the traction device used in such a conventional minimally invasive surgical method, it has a disadvantage in that it is simply cylindrical and made of an opaque material, making it difficult to secure a field of view and fix the position at the surgical site.

Korean Utility Model Registration No. 20-0360581 Korean Patent Publication No. 10-2003-0066111

One aspect of the present invention provides a tubular retractor for microinvasive surgery that enables insertion of an intervertebral cage that could not be inserted through a conventional retractor, and enables micro-resected body parts or nerve locations to be visually confirmed. do.

In addition, it provides a tubular retractor for microinvasive surgery implemented to prevent nerves from approaching the affected area during surgery, and is fixed to the spine to prevent the retractor from moving during surgery.

The technical problem of the present invention is not limited to the technical problem mentioned above, and other technical problems that are not mentioned will be clearly understood by those skilled in the art from the following description.

The tubular retractor for microinvasive surgery according to an embodiment of the present invention has both wing portions to be inserted into the patient's body through the micro-resected space to insert surgical equipment to the affected area requiring surgery through the internal space. An insertion tube that is bent in an inward direction until they face each other at a predetermined interval to form a round tube shape with one side open; And a nerve support that extends in a longitudinal direction from an end of the other side opposite to one side of the insertion tube so as to prevent the nerve from approaching the affected area during surgery to support the nerve to the outer surface.

In one embodiment, the insertion tube may include a locking jaw protruding along an outer circumferential surface so as to prevent being pushed out of the body by pressure of the patient's body tissue when inserted into the patient's body.

In one embodiment, the locking jaw may be formed in a truncated cone shape that becomes narrower toward the nerve support.

In an embodiment, a plurality of the locking jaws may be formed at predetermined intervals.

In one embodiment, the insertion tube and the nerve supporter may be formed of a transparent material so that a finely excised body part or a position of a nerve can be identified.

In one embodiment, the insertion tube may be formed to decrease in thickness while going from the center portion toward both wings.

In one embodiment, the insertion tube, a pin insertion hole formed through the direction of the other end of the nerve support is extended from a central portion of one end; And a fixing pin that is inserted through the pin insertion hole, one side is fastened to the pin insertion hole, and the other side is exposed to the outside of the pin insertion hole to be inserted into the bone of the patient.

In one embodiment, the pin insertion hole may be formed obliquely in an outward direction from a central portion of one end of the insertion tube so that the other side of the fixing pin can be exposed to the outside.

In one embodiment, the nerve support may include a tapered portion formed at an end of which the thickness decreases while going to the distal end.

In one embodiment, the insertion tube may be formed such that the diameter gradually decreases from one end to the other end in which the nerve support is extended.

According to one aspect of the present invention described above, it is possible to visually check the position of the finely excised body part or nerve, so that medical accidents such as nerve damage that may occur during surgery can be prevented in advance.

In addition, it is possible to prevent the nerve from approaching the affected area during surgery or the retractor from moving during the surgery, thereby increasing the success rate of surgery.

1 is a view of a tubular retractor for microinvasive surgery according to an embodiment of the present invention.
2 is a partial enlarged view of the tubular retractor for microinvasive surgery of FIG. 1.
3 is a view showing an example of use of the tubular retractor for microinvasive surgery of FIG. 1.
4 is a view of a tubular retractor for microinvasive surgery according to another embodiment of the present invention.
5 and 6 are views showing examples of use of the tubular retractor for microinvasive surgery of FIG. 4.

DETAILED DESCRIPTION OF THE INVENTION The detailed description of the present invention to be described later refers to the accompanying drawings, which illustrate specific embodiments in which the present invention may be practiced. These embodiments are described in detail sufficient to enable a person skilled in the art to practice the present invention. It is to be understood that the various embodiments of the present invention are different from each other, but need not be mutually exclusive. For example, certain shapes, structures, and characteristics described herein may be implemented in other embodiments without departing from the spirit and scope of the present invention in relation to one embodiment. In addition, it is to be understood that the location or arrangement of individual components within each disclosed embodiment may be changed without departing from the spirit and scope of the present invention. Accordingly, the detailed description to be described below is not intended to be taken in a limiting sense, and the scope of the present invention, if properly described, is limited only by the appended claims, along with all scopes equivalent to those claimed by the claims. In the drawings, like reference numerals refer to the same or similar functions over several aspects.

Hereinafter, preferred embodiments of the present invention will be described in more detail with reference to the drawings.

1 is a view of a tubular retractor for microinvasive surgery according to an embodiment of the present invention.

Referring to FIG. 1, a tubular retractor 10 for microinvasive surgery according to an embodiment of the present invention includes an insertion tube 100 and a nerve support 200.

The insertion tube 100 is inserted into the patient's body through a minimally invasive micro-resected space so that the surgical equipment can be inserted through the internal space to the affected area requiring surgery. To 11mm, for example, 9mm, etc.), bending inwardly until they face each other to form a round tube shape with one side open, and a nerve support 200 extending from an end of the other side opposite to one side.

In the present invention, the term'minimum invasive' means minimizing the degree of damage to the surgical site, and after creating an operating window of about 10 to 30 mm on the patient's surgical site, the internal surgical site is gradually After inserting a cylindrical dilator for expansion, the present invention is inserted into a portion where the cylindrical dilator is inserted to minimize damage to the surgical site.

Existing expandable cages (devices that are inserted between the vertebrae to expand the space between the vertebral bodies in the vertical direction) can be inserted into the patient's vertebral bodies through the space formed by the retractor as it is formed with a size larger than the inner diameter of a general retractor. It had the disadvantage of not having it.

Accordingly, the insertion tube 100 according to the present invention, as shown in FIG. 1, in the case of an expandable cage that is formed to be larger than its inner diameter as one side is formed to be open, a part of the expandable cage is opened space It is possible to insert an expandable cage that conventional retractors could not.

In one embodiment, the insertion tube 100 may be manufactured in various lengths or diameters corresponding to the depth of the affected area to be inserted or the resected space, and the length is approximately corresponding to the standard of a retractor generally used in microinvasive surgery. 65mm to 75mm, for example, 70mm, outer diameter of about 13mm to 19mm, for example 16mm, about inner diameter of 11mm to 15mm, for example, it may be made of 13mm.

In one embodiment, the insertion tube 100 is formed so as to be thinner while going from the center portion to both sides of the wing, so that it can efficiently support the pressure applied from the body tissue after being inserted into the patient's body, Both sides of the wings, which are relatively thin, are elastically contracted in response to the pressure of the body tissue, so that the shape thereof can be deformed in response to the pressure of the body tissue.

In one embodiment, the insertion tube 100 is formed to gradually decrease in diameter while going from one end to the other end where the nerve support 200 is extended so that insertion into the body part of the resected patient can be efficiently performed (for example, , If the outer diameter of one end of the insertion tube 100 is 16mm as described above, the outer diameter of the other end is made of 13mm, etc.).

Referring to FIG. 2, the insertion tube 100 includes a locking jaw 110 protruding along the outer circumferential surface to prevent being pushed out of the body by the pressure of the patient's body tissue when inserted into the patient's body. Include.

In one embodiment, the locking jaw 110 is a circular truncated cone (circular truncated cone, which does not include the vertex of the cone among two three-dimensional figures formed by cutting the cone into a plane parallel to the bottom surface) that becomes narrower in the direction of the nerve support 200 By being formed in the shape of a figure made of a cut surface and a patient's body, it can be prevented from being pushed out of the body during surgery by pressure applied from the body tissue after being inserted into the patient's body.

Accordingly, the insertion tube 100 is fixed inside the patient's body by the locking jaw 110, even without having a separate fixing device such as a clip, so that the insertion tube 100 is pushed out of the patient's body during the operation to interfere with the operation. You will be able to prevent receiving it.

In one embodiment, a plurality of locking jaws 110 may be formed at predetermined intervals (about 10 mm to 14 mm, for example, 12 mm, etc.) corresponding to the type of surgery or the body position to be inserted.

In FIG. 2, three locking jaws 110 are formed, but less than three or more than three may be formed corresponding to the type of surgery or the body position to be inserted.

That is, in the case of a body part where strong pressure can be applied to the insertion tube 100 due to a large number of muscles, 4 to 5 parts are formed, whereas a body part where only a small pressure can be applied through the insertion tube 100 because there are not many muscles. In the case of, 1 to 2 may be formed.

The nerve support 200 is formed extending in the longitudinal direction from the end of the other side opposite to one side of the insertion tube 100 so as to prevent the nerve from accessing the affected area during surgery to support the nerve to the outer surface.

In one embodiment, the nerve support 200 is made of about 45mm to 55mm, for example, 50mm from the end of the insertion tube 100 so that it can be sufficiently extended to the place where the nerve is located, as shown in FIG. Can be.

Referring to FIG. 2, the nerve support 200 is thinner as it goes to the distal end (for example, when the thickness of the nerve support 200 is 3.5 mm, the thickness of the distal end of the nerve support 200 is 2.5 mm. Etc.) By including the tapered portion 210 formed at the end, not only can it be more easily inserted into the patient's body, but also the nerve is moved during the operation or the nerve is moved to the affected area by placing the nerve on the tapered portion 210. You can prevent access.

In the case of conventional spinal surgery, surgical equipment such as a microscope is inserted into the affected area through a traction device, and during the operation, nerves passing through the spine approach the affected area in operation, thereby interfering with the operation.

Accordingly, in the present invention, by using the nerve support 200 to prevent the nerve from accessing the affected area during surgery, it is possible to prevent the operation from being unexpectedly disturbed.

Existing retractors for microinvasive surgery were made of opaque materials (e.g., stainless steel, etc.), making it difficult for the operator to visually check the area being operated, and the body tissue supported by the retractor itself was also visible with the naked eye. It was difficult to identify, so it was difficult to respond quickly to changes in the state of the body tissues during surgery.

Accordingly, the insertion tube 100 and the nerve support 200 of the tubular retractor 10 for microinvasive surgery having the configuration as described above are formed of a transparent material so that the position of the micro-resected body part or nerve can be confirmed. , It can solve the problems of the existing microinvasive surgical retractor.

In addition, the tubular retractor 10 for microinvasive surgery can be used as long as it is made of a transparent material that is harmless to the human body and has high strength, for example, polyethylene, polypropylene, polystyrene, or polyvinyl chloride having a transparent color. It can be made of plastic.

In addition, it is possible to easily read the position of the nerve by using the nerve support 200 made of a transparent material, and effectively prevent the nerve from accessing the affected area during surgery.

The tubular retractor 10 for microinvasive surgery having the configuration as described above can be generally applied to surgery, and is preferably used for minimally invasive surgery to secure the field of view and fix the position of the surgical site. It may, more preferably, be used in surgery related to all spinal diseases such as degenerative intervertebral disc disease, spinal cavity stenosis or spondylolisthesis, and all spinal diseases such as spinal trauma.

4 is a view of a tubular retractor for microinvasive surgery according to another embodiment of the present invention.

4, a tubular retractor 20 for microinvasive surgery according to another embodiment of the present invention includes an insertion tube 100 and a nerve support 200. Here, the locking jaw 110 and the nerve support 200 of the insertion tube 100 are substantially the same as the components of FIG. 1, so a description thereof will be omitted.

The insertion tube 100 further includes a pin insertion hole 120 and a fixing pin 130.

The pin insertion hole 120 is formed through the central portion of one end (ie, the portion having the thickest thickness of the insertion tube 100) in the direction of the other end of which the nerve support 200 is extended, as shown in FIG. 4, It is formed with a diameter corresponding to the thickness of the fixing pin 130.

In one embodiment, the pin insertion hole 120 may be formed obliquely in an outward direction from a central portion of one end of the insertion tube 100 so that the other side of the fixing pin 130 can be exposed to the outside.

As the fixing pin 130 is inserted through the pin insertion hole 120, one side is fastened to the pin insertion hole 120, and the other side is exposed to the outside of the pin insertion hole 120 and inserted into the bone of the patient. .

The nerve support 200 of the present invention, as shown in FIG. 5, is directed toward a portion where there is no fear of nerve damage (that is, one side of the insertion tube 100 in which the nerve support 200 is not formed is in the nerve direction. After being inserted), as shown in FIG. 6, as the insertion tube 100 rotates so as to support the nerve to the outer surface, it rotates together.

When the nerve support 200 supports the nerve through the outer surface as shown in FIG. 6, the fixing pin 130 is inserted through the pin insertion hole 120 and then into the bone, muscle or skin tissue around the patient's spine. By being inserted and fastened, it is possible to prevent the insertion tube 100 from rotating.

The tubular retractor 20 for microinvasive surgery having the configuration as described above is, after inserting a fixed wire and a serial dilation into an affected area requiring surgery, the insertion tube 100 and the nerve support as described above ( After the insertion and rotation of 200) and the fastening process of the fixing pin 130, it can be used as a method of removing the continuous expander from the affected part.

Existing traction devices do not have a separate fixing device, so they are not fixed to the affected part even after being inserted into the patient's body, and they come out of the resected patient's body or unintentionally rotate within the patient's body during surgery. There were cases of moving contrary to the intention of the operator, such as doing so.

Accordingly, as the insertion tube 100 having the configuration as described above is fixed to the affected part of the patient through the fixing pin 130, unintended movement occurring in the conventional traction device as described above occurs. It can be prevented in advance.

Although the above has been described with reference to embodiments, it is understood that those skilled in the art can variously modify and change the present invention without departing from the spirit and scope of the present invention described in the following claims. You can understand.

100: insertion tube
110: stopping jaw
120: pin insertion hole
130: fixing pin
200: nerve support
210: tapered portion

Claims (10)

Both wing portions are bent in the inward direction until they face each other at a predetermined interval so that the surgical equipment can be inserted through the micro-resected space into the patient's body through the internal space to the affected area requiring surgery. Insertion tube forming an open round tube shape; And
It includes a nerve support that extends in the longitudinal direction from the end of the other side opposite to the one side of the insertion tube to support the nerve to the lateral surface so as to prevent the nerve from approaching the affected area under surgery,
The insertion tube,
A pin insertion hole through which the nerve support extends from the central portion of one end toward the other end; And
One side is fastened to the pin insertion hole while being inserted through the pin insertion hole, and the other side is exposed to the outside of the pin insertion hole and includes a fixing pin inserted and fastened into the bone of the patient,
The pin insertion hole,
A tubular retractor for microinvasive surgery, which is formed obliquely in an outward direction from the central portion of one end of the insertion tube so that the other side of the fixing pin can be exposed to the outside.
The method of claim 1, wherein the insertion tube,
A tubular retractor for microinvasive surgery, including a locking jaw protruding along an outer circumferential surface to prevent being pushed out of the body by the pressure of the patient's body tissue when inserted into the patient's body.
The method of claim 2, wherein the locking jaw,
A tubular retractor for microinvasive surgery, which is formed in a truncated cone shape that becomes narrower toward the nerve support.
The method of claim 2, wherein the locking jaw,
A tubular retractor for microinvasive surgery, which is formed in plural at predetermined intervals.
The method of claim 1,
The insertion tube and the nerve support, a tubular retractor for microinvasive surgery, which is formed of a transparent material so as to confirm the position of a finely excised body part or nerve.
The method of claim 1, wherein the insertion tube,
A tubular retractor for microinvasive surgery, which is formed to be thinner while going from the center to both wings.
delete delete The method of claim 1, wherein the nerve support,
A tubular retractor for microinvasive surgery, including a tapered portion formed at an end that becomes thinner while going to the end.
The method of claim 1, wherein the insertion tube,
A tubular retractor for microinvasive surgery, which is formed to gradually decrease in diameter while going from one end to the other end of the nerve support.

Images