WO2013191388A1

WO2013191388A1 - Guide protractor for ventricular puncture applied to ventriculoperitoneal shunting

Info

Publication number: WO2013191388A1
Application number: PCT/KR2013/004666
Authority: WO
Inventors: 박재찬; 강동훈; 우현진
Original assignee: 경북대학교 산학협력단
Priority date: 2012-06-21
Filing date: 2013-05-28
Publication date: 2013-12-27
Also published as: KR20130143352A; KR101420247B1

Abstract

The present invention relates to a guide protractor for a ventricular puncture applied to ventriculoperitoneal shunting, comprising: a base portion into a drilled hole of the skull and having a C-shaped insertion hole through which an insertion tube for the ventricular puncture is inserted; and a guide protractor which is fastened to the upper portion of the base portion and has a guide groove for guiding the insertion direction of the ventricular puncture. Therefore, the present invention provides a guide protractor for a ventricular puncture which allows a simple and precise operation of a ventricular puncture through a drilled hole of the skull in ventriculoperitoneal shunting and allows rapid operation ventriculoperitoneal shunting.

Description

【Specification】

[Name of invention]

Intraocular prosthetic device for ventricular perforation applied to ventricular ablation

Technical Field

The present invention relates to an intraocular prosthetic device, and more particularly, to an intraocular prosthetic device for precisely performing penentriculostomy, which is a ventriculoperitoneal shunting procedure performed to treat hydrocephalus.

Background Art

In general, ventriculoperitoneal shunting is a surgery performed to treat hydrocephalus of various causes. After perforating the skull, puncture the ventricles and tunneling the subcutaneous (tunnel ling) from here, using a separate incision in the abdomen using a shunt system (Catheter) is inserted into the abdominal cavity.

In this operation, a method of puncturing the ventricle in the deep part of the brain in the perforation of the skull is required. For this, a method such as puncturing toward the center of the brain or using a device such as neuronavigation is used depending on the operator's experience. This is used.

However, there was no reliable device or method that could perform ventricular puncture precisely without complicating the procedure of surgery and prolonging the operation time.

Detailed description of the invention

[Technical problem]

An object of the present invention to solve the above-mentioned problem is to provide a brain apparatus for guiding prosthetic device that can perform a simple and accurate brain performer through a skull perforation, as well as a fast brain practice. Technical Solution

A first aspect of the present invention for solving the above problems, the base portion is inserted into the cranial perforation, C-shaped insertion hole for inserting the insertion tube for ventricular puncture; And a guide protractor which is fastened to an upper portion of the base and has a guide groove for guiding the direction of insertion of the ventricular puncture.

Here, the base portion, the bottom plate with a certain opening is opened (: the bottom plate is formed in the same direction, the c-type hole is the same in the opening direction, protrudes to the lower portion of the base plate and inserted into the perforation, and The opening direction of the C-type hole is the same, it is preferable to be provided with a C-type upper protrusion tube protruding to the upper portion of the base plate and fastened to the guide protractor.

In addition, the base plate is preferably one of which is wider with respect to the opening direction, the thickness of the base plate of the wide structure may be thinner in the outer direction, the opening direction of the C-type hole on the base plate upper surface At least one line parallel to the, and perpendicular to the open direction of the C-type hole, the line passing through the center of the C-type hole may be displayed.

In addition, the guide protractor is fastened to the outside with the upper protrusion tube

It is preferable to include a C-shaped fastening tube, and a divider plate extending in the longitudinal direction of the fastening tube, and a divider plate marked with a predetermined rotation angle from a vertical line with respect to the base plate, wherein the guide groove rotates in the divider plate. Preferably, the ^angle is located between 20 ^° and 25 ^° . And, the second feature of the present invention is inserted into the skull perforation, the base portion is formed C-shaped insertion hole for inserting the insertion tube for ventricular puncture; C-type fastening pipe fastened to the base portion; And a guide protractor mounted to the upper part of the fastening tube and a guide device mounted on the divider to guide the ventricular puncture insertion direction and capable of rotating or fixing in a predetermined angle range.

Here, the base portion, the base plate is formed a C-type hole is a part of which is open, the C-type hole is the same in the opening direction of the base plate, protruding to the lower portion of the base plate and inserted into the perforation, and the It is preferable that the opening direction of the C-type hole is the same and is provided as a C-type upper protrusion tube which protrudes to the upper portion of the base plate and is engaged with the guide protractor. In addition, the base plate has a structure in which either side is wide around the opening direction, the thickness of the base plate of the wide structure is preferably thinner in the outward direction, parallel to the opening direction of the c-type hole on the base plate upper surface Preferably, at least one line and a line perpendicular to the open direction of the C-type hole and passing through the center of the C-type hole are displayed.

In addition, preferably, the guide device, the fastening support is installed on the upper edge of the divider plate and rotatable along the edge; A support extending from the support to the lower center of the divider plate; And a guide hook installed at an upper portion of the support and partially opening upwardly of the divider to guide the brain implementer and to guide the insertion direction, wherein the guide device is 20 ^° of the divider. It can be seen that it can be rotated or fixed in the range of 25 ^° .

In addition, the guide device preferably includes a clamp-type fastening support detachable to the divider rim, a C-shaped guide tube extending vertically downwardly from the fastening support and guiding the ventricular insertion direction. At least one fastening plate is formed at the bottom of the plate, and the fastening pipe is preferably formed with a fastening groove into which the fastening plate is inserted.

Advantageous Effects

As described above, the present invention provides not only a simple but accurate ventricular puncture through the perforation of the skull in ventricular abdominal pulmonary pulmonary surgery, but also provides an intraocular ventricular device capable of rapidly performing ventricular puncture. In addition, it is possible to easily set the most suitable insertion angle of the brain performer according to the patient, the insertion length is clearly confirmed to provide an auxiliary device for precise brain practice.

[Brief Description of Drawings]

1 is a view showing the configuration of an intraocular prosthetic device for ventricular perforator for ventricular abdominal cavity according to an embodiment of the present invention

Figure 2 is a view showing a fastening configuration of the intraocular prosthetic device for ventricular perforator for ventricular abdominal cavity according to an embodiment of the present invention, Figure 3 is another embodiment of the present invention, a view showing the configuration of an intraocular prosthetic device for ventricular pulmonary ventricular pulmonary pulmonary pulmonary ventilator is installed,

Figure 4 is another embodiment of the present invention, a view showing the configuration of an intraocular prosthetic device for ventricular perforator for ventricular abdominal shunting with a locking device,

5 is a view showing the configuration of a guide dispenser equipped with a removable guide device as another embodiment according to the present invention. Best Mode for Implementation of the Invention

1 is a view showing the configuration of an intraocular prosthetic device for ventricular perforator for ventricular abdominal shunting according to an embodiment of the present invention. Figure 1 (a) is a view showing the structure of the base portion to form a hole for inserting the brain performer, Figure 1 (b) is fastened to the base portion 100, the guide for inserting the insertion tube for the brain ventricle 2 is a diagram illustrating the structure of the guide protractor 200 in which the groove 250 is formed.

As shown in Figure 1, the guide prosthesis device for ventricular ventricular ventricular ventilator for ventricular abdominal shunting is inserted into the skull perforation, the base portion formed with a C-shaped insertion hole for inserting the insertion tube for ventricular puncture (Basement Portion: Part 1) And it is configured to include a guide protractor 200 (Guiding Protractor: Part 2) formed with a guide groove 250 is fastened to the upper portion of the base portion 100 to guide the direction of insertion of the ventricular puncture.

[Form for implementation of invention]

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

1 is a view showing the configuration of an intraocular prosthetic device for ventricular perforator for ventricular abdominal shunting according to an embodiment of the present invention. Figure 1 (a) is a view showing the structure of the base portion to form a hole for inserting the brain performer, Figure 1 (b) is fastened to the base portion 100, guide for inserting the insertion tube for cerebral practitioner 2 is a diagram illustrating the structure of the guide protractor 200 in which the groove 250 is formed.

As shown in Figure 1, for ventricular perforator for ventricular abdominal shunting An intraocular device is inserted into the cranial perforation and inserts an insertion tube for ventricular puncture.

Base portion 100 having a C-shaped insertion hole (Basement Portion: Part 1); and a guide protractor 200 having a guide groove 250 that is fastened to an upper portion of the base portion 100 to guide the direction of insertion of the ventricle. Protractor: Part 2).

The base portion 100 inserted into the skull perforation is provided with a base plate 110 (Basement Plate) of 3 cm in width and length, respectively, and on the upper surface of the base plate 110 is the midline or sagittal suture of the skull. The Parasagittal line, a line parallel to the line, is drawn and placed parallel to the midline or sagittal suture of the skull.

In addition, the base portion 100 is provided with a protruding tube having an outer diameter of 12 mm3 in a C shape adjacent to one edge thereof, and the protruding tube has a C shape in which one side is open, and is punctured into the ventricle after completion of ventricular puncture. The base 100 can be easily removed without touching the silicone catheter. C-shaped lower protrusion tube 130 in the base portion 100 is inserted into the skull perforation serves to fix the base portion 100, the upper protrusion tube 140 is connected to the guide protractor 200 Perform negative functions. It is preferable that the thickness of the base plate 110 in the base 100 is gradually thickened from the C-shaped protrusion pipe to the C-shaped protrusion pipe from the far edge to the C-shaped protrusion pipe so as to have a thickness difference of 3 mm. This is to ensure that the upper surface is positioned horizontally with the coronal plane of the head.

In addition, the fastening tube 240 of the guide protractor 200 which is connected to the C-shaped upper protrusion tube 140 in the base portion 100 is silicon installed after the completion of cerebral percutaneous puncture in the form of a C-shaped one of which is open. The intraocular protractor can be easily removed without touching the tube. Here, the fastening pipe 240 of the guide centrifuge 200 is a structure that can be connected and rotated wrapped around the upper protrusion pipe 140 of the base plate 110 with an inner diameter of 12 画.

In the guide protractor 200, the angle from the sagittal plane of the skull is preferably displayed from 0 degrees to 40 degrees, and long guide grooves 250 are formed at 20 to 25 degrees from the sagittal plane of the skull. It is desirable to guide the ventricular catheter. And It is preferable to place an arrow on the 40-degree edge of the guide protractor 200 so as to rotate the guide protractor so as to face the tragus.

As described above, the apparatus for intraocular prosthesis 200 according to an embodiment of the present invention has a problem in the conventional method of puncturing or using a device such as neuronavigation according to the operator's experience in performing the brain performer. In order to solve the problem, by proposing an intraocular prosthesis 200 for guiding the optimal angle to insert the catheter, it provides an instrument that the operator can easily and accurately perform the brain performer.

In more detail, as shown in (a) of FIG. 1, the base part 100 has a base plate 110 having a C-shaped hole in which a part thereof is opened, and a direction in which the C-type hole is opened in the same manner, C-type lower protrusion tube 130 and protrudes to the lower portion of the 110 and inserted into the perforation, the opening direction of the C-type hole is the same, and protrudes to the upper portion of the base plate 110 to guide the protractor 200 It is provided with a C-type upper protrusion tube 140 is fastened with. The upper protrusion tube 140 and the lower protrusion tube 130 may be a C-type tube formed integrally. The base plate 110, the upper and lower protrusion tube 130 has an open structure on either side, the base plate is inserted into the perforation of the skull to insert a ventricular catheter along the insertion hole, and then again includes the base plate 110 This is to remove the guide protractor 200 device without contact with the inserted silicone tube or catheter. The guide protractor 200 has a C-shaped fastening pipe 240 fastened from the upper protrusion pipe 140 and an outer side thereof, a half-shape shape extending in the longitudinal direction of the fastening pipe 240, and the base plate 110. And a divider plate 210 with a predetermined dipole angle from the vertical line. That is, the guide prosthesis 200 is mounted to the base portion 100 through the fastening tube 240, and the catheter is inserted into the insertion hole along the guide groove 250 already formed at the most suitable angle to perform the brain practitioner. . 2 is a view showing a fastening configuration of the apparatus for the intraocular prosthesis 200 for ventricular peritoneum for ventricular ablation according to an embodiment of the present invention. As shown in FIG. 2, the opening is the same as a splice for coupling the fastening tube 240 of the guide protractor 200 to the upper portion of the upper protrusion tube 140 of the base 100 inserted into the cranial puncture. The guide protractor 200 can be rotated at the upper portion of the upper protrusion tube 140 so that it can fit. Aligning the opening is equally intended to safely separate the guide protractor 200 device from the catheter after the catheter is inserted through the insertion hole.

Guide groove 250 is a structure for guiding the most suitable insertion angle for ventricular ventricular pulmonary ventricular pulmonary pulmonary perforator, the catheter can be inserted along the guide groove 250, it is possible to perform accurate and rapid Will be. The ventricular abdominal short-circuit surgery used in the embodiment of the present invention looks at the method of using the intraocular prosthetic device 200 according to the embodiment of the present invention according to a standard surgical method.

First, a borehole is performed 1 cm before the point where the line parallel to the outer side of the midline of the skull and the coronal suture line meet or 1 cm from the point. The perforated C-type lower protrusion tube 130 in the base portion 100 of the apparatus 100 according to the embodiment of the present invention is inserted into this perforation, and the parasagi in the base plate 110 of the base portion 100 is inserted. The parasagittal line is placed parallel to the midline of the skull.

As shown in FIG. 2, the base plate 110 has a wide structure in which either side of the base plate 110 is opened, and the thickness of the base plate 110 having the wide structure is thinned outward. When the lower protrusion tube 130 is inserted into the perforation, the upper surface of the base plate 110 is horizontally positioned on the upper surface of the skull by pressing a portion where the thickness becomes thicker with the finger and close to the skull.

That is, since the distance between the base plate 110 and the skull increases as the skull has a spherical shape, the wide structure of the base plate 110 is directed toward the center of the skull, and the lower protrusion tube 130 is placed in the perforation. Insertion forms a stable horizontal insertion structure on the top of the skull. Then, the fastening tube 240 of the guide protractor 200 is inserted into the C-type upper protrusion tube 140 of the base 100, and the arrow of the guide protractor 200 is 1 cm in front of the trachea of the ipsilateral ear. Rotate to face Finally, the catheter (Ventricular Catheter) is a guide groove (250) Use it to puncture the brain at an angle of 23 degrees and puncture the ventricles. Here, the insertion angle of the guide groove 250 is preferably set within the range of 20 degrees to 25 degrees.

The angle may be measured for each patient using a coronal image of MRI or CT of the head, and puncturing the ventricles using the intraocular prosthesis 200 according to the obtained angle. Subsequent surgical procedures follow the general method of ventricular ablation. 3 is a view showing the configuration of an apparatus for intraocular prosthesis 200 for ventricular peritoneum for ventricular abdominal short surgery as another embodiment of the present invention. As shown in FIG. 3, the base 100 is the same as that of FIGS. 1 and 2, but is mounted on the divider 210 in the guide protractor 200 to guide the ventricular puncture insertion direction and rotate in a predetermined angle range. Or there is a difference in that the guide device 260 that can be fixed is installed.

The guide device is a device for guiding the silicon tube or catheter in the direction of the perforation of the skull, the fastening support portion 261 is installed on the upper edge of the divider plate 210 and rotatable along the edge; A support 263 extending from the support to the lower center of the divider 210; And a guide hook 265 installed at an upper portion of the support 263 and partially opening upwardly of the divider plate 210 to guide and support the brain performer and guide an insertion direction.

As described above, the catheter is inserted in the cerebral sagittal plane in the direction of catheter insertion. However, since the most appropriate insertion angle can be found in the range of 20 to 25 degrees, as shown in FIG. It is proposed a structure that allows the guide device 260 for guiding the catheter between FIGS.

As described above, the guide device 260 mounted on the guide protractor 200 device according to the embodiment of the present invention includes a fastening support part 261 rotatable along the edge of the divider plate 210, and perpendicular to the insertion hole direction in the fastening support part. By consisting of an extended support 263 and at least one guide hook 265 provided on the support, it is possible to selectively and conveniently adjust the appropriate insertion angle. Figure 4 is another embodiment of the present invention, it is a view showing the configuration of an intraocular prosthetic device for ventricular perforator for ventricular abdominal laparotomy with a locking device. The other configuration is the same as the embodiment of Figs. 1 and 2, and unlike the embodiment of Fig. 3 as a structure in which the guide device 270 is mounted, the fastening support 271 can selectively fix or release the rotation. When the locking device is installed, and the scale is displayed on the support, when the catheter is inserted, the guide device which can confirm the insertion length is proposed.

That is, since the locking type locking part 272 is provided in the side part of a fastening support part, when the said locking part 272 is moved to the left and right, the lower end part of the fastening part 271 and the edge of the divider plate 210 contact pressure. This change is made to select the locking or unlocking of the rotation, and since the scale is marked on the surface of the support 273 extending perpendicular to the fastening support 271, when the catheter marked with the insertion point is inserted, the insertion is performed. Figure 5 is another embodiment according to the present invention, showing the configuration of a guide protractor equipped with a detachable guide device, as shown in Figure 5, the guide device 280 ， Clamp-type fastening support part 281 which is detachable to the edge of the divider plate 210, extends vertically downward with the fastening support part 281, and guides the direction of insertion of the ventricle And a guide tube 283. In this way, the guide device 280 can be selectively fitted to the edge of the divider plate 210 through the forceps-type fastening support 281, so that the insertion angle of the catheter can be inserted into the patient. According to the most appropriate selection can be used.

That is, the forceps-type fastening support 281 is easily inserted into the divider plate by using a plastic material having a constant elasticity, and by using a handle formed by forming a hum on one side of the forceps-type fastening support 281, it is convenient for use. Can increase. In addition, the hook 285 is installed on the forceps-type fastening support 281 so that the hook 285 can be hung on a wall, and the guide device 280 can be used as a handle used to detach the guide device 280 from the divider plate 210. .

The C-type guide tube 283 of the guide device is a guide for guiding insertion of the ventricular catheter, and is preferably formed of a C-type tube with an open top. Such a guide tube 283 extends vertically downward to the tong-shaped support 281 is When mounted on the divider plate 210, it is positioned in the insertion hole direction to perform a function of guiding the insertion direction of the catheter. Although the preferred embodiments of the present invention have been described above, the present invention is not limited to the above embodiments, and easily changed and equalized by those skilled in the art from the embodiments of the present invention. It includes all changes to the extent deemed acceptable.

Industrial availability

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an intraocular prosthetic device for precisely performing penentriculostomy, a procedure such as Ventriculoperitoneal Shunting, which is performed to treat hydrocephalus.

Claims

[Range of request: I

[Claim 1]

A base portion inserted into the cranial perforation and having a c-type insertion hole for inserting an insertion tube for ventricular puncture; And

Guidance prosthesis device for a brain performer, characterized in that it is fastened to the upper portion of the base portion guide guides formed with a guide groove for guiding the direction of insertion of the ventricle.

[Claim 2]

The method of claim 1,

The base portion,

A base plate on which a c-shaped hole is formed, the part of which is open;

A c-type lower protrusion tube which is opened in the same direction as the C-type hole and protrudes below the base plate and is inserted into the perforation;

The C-shaped hole opening direction is the same, protruding apparatus for the brain performer, characterized in that the protruding to the upper portion of the base plate is provided with a C-type upper protruding tube coupled to the guide protractor.

[Claim 3]

The method of claim 2,

The base plate has a guide structure for the brain performer, characterized in that one side is a wide structure around the opening direction, the thickness of the base tube of the wide structure is thinner in the axial direction.

[Claim 4]

The method of claim 3,

At least one line parallel to the open direction of the C-type hole, a line perpendicular to the open direction of the C-type hole, and a line passing through the center of the C-type hole are displayed on the upper surface of the base plate. One protractor device. -Claim 5

The method of claim 2,

The guide protractor,

C-type fastening pipe fastened from the upper protrusion pipe and the outside,

5. An intraocular prosthetic device according to claim 1, further comprising a divider plate extending in the longitudinal direction of the fastening tube and having a predetermined rotational angle indicated from a vertical line with respect to the base plate.

[Claim 6]

0 according to claim 5,

The guide groove is an intraocular prosthetic device for a brain performer, characterized in that the rotation angle is located between 20 ° to 25 ° in the divider plate.

[Claim 7]

5 a base inserted into the cranial perforation and having a C-shaped insertion hole for inserting an insertion tube for ventricular puncture;

C-type fastening pipe fastened to the base portion; And

And a guide protractor mounted to the upper part of the fastening tube, and a guide protractor mounted to the divider to guide the ventricular puncture insertion direction and provided with a guide device capable of rotating or fixing within a predetermined angle range. Protractor device for.

[Claim 8]

The method according to claim 7,

5 The base portion,

A base plate on which a part of the C-shaped hole is opened;

The lower direction of the opening of the C-shaped hole is the same, and protrudes to the lower portion of the base plate and inserted into the perforation,

The C-shaped hole opening direction is the same, 0 protruder apparatus for brain ventricle, characterized in that provided with a C-type upper protrusion tube is protruded to the upper portion of the base plate and coupled to the guide protractor.

[Claim 9]

The method of claim 8,

The base plate has a wider structure on either side of the base plate to open the guide prosthesis device for a brain performer, characterized in that the thickness of the base plate of the wide structure becomes thinner in the outward direction.

[Claim 10]

The method of claim 9,

At least one line parallel to the open direction of the C-type hole, a line perpendicular to the open direction of the C-type hole, and a line passing through the center of the C-type hole are displayed on the base plate upper surface. Guide protractor device.

[Claim 11]

The method of claim 7,

The guide device,

A fastening support installed at an upper edge of the divider plate and rotatable along the edge;

A support extending from the support to the lower center of the divider plate; And a guide hook installed at an upper portion of the support and partially opened upwardly of the divider to guide and guide the insertion direction of the brain performer.

[Claim 12]

According to claim 7,

The guide device is an intraocular prosthetic device for the brain performer, characterized in that the rotation or fixation in the range between 20 ° to 25 ° of the divider plate.

[Claim 13]

The method of claim 7, The guide device,

And a clamp-type fastening support detachable to the divider rim, and a C-shaped guide tube extending vertically downwardly from the fastening support and guiding the direction of insertion of the ventricle.

[Claim 14]

The method according to any one of claims 7 to 13,

At least one fastening plate is formed at the lower portion of the divider plate,

The fastening tube is an intraocular prosthesis device for a brain performer, characterized in that the fastening groove is formed is inserted into the fastening plate.