WO2016144116A1

WO2016144116A1 - Retractor assembly for minimally invasive surgery

Info

Publication number: WO2016144116A1
Application number: PCT/KR2016/002403
Authority: WO
Inventors: 김현성; 허동화; 윤홍원
Original assignee: 김현성; 주식회사 메드릭스
Priority date: 2015-03-10
Filing date: 2016-03-10
Publication date: 2016-09-15
Also published as: KR20160003152U; KR200481475Y1

Abstract

The present device relates to a retractor assembly for minimally invasive surgery, comprising: a main body which is inserted through an opening of a patient, has a channel formed therein, and of which both ends are penetrated; and a tip unit which is provided on the distal end of the main body, and of which the edge of the end portion is formed to correspond to the shape of the outline of the patient's bone which is the part subject to surgery. Thus, the retractor assembly for minimally invasive surgery is capable of stable and reliable surgery without touching sensitive and dangerous parts such as body fluid tubes through which body fluids flow, blood vessels, and ligaments.

Description

Minimally Invasive Retractor Assembly

The present invention relates to a retractor assembly for minimally invasive procedures, and more particularly, a retractor for minimally invasive procedures that enables a stable and reliable procedure without touching sensitive and dangerous areas such as bodily fluids, blood vessels, or ligaments. It is about assembly.

The discs between the vertebrae and the bones function as joints, and as the spine moves, the position and shape of the nucleus pulposus inside the disc changes, which plays a very important role in minimizing the impact on the spine.

Most of the nucleus of the nucleus is composed of water (water). As the body ages, the amount of water gradually decreases, and the disk loses its buffer function.

Due to this, excessive pressure is applied to the fiber, which causes back pain, and further progresses, when the fiber is severely stretched or ruptured, pressing the nerve root located at the back causes pain in the pelvis and legs.

Since the spine is gradually narrowed or spine deformed as the vertebral bones settle down, various side effects occur.

As a method of treating the disease accompanying the disc, there is a method of removing the damaged intervertebral disc and replacing the space between two adjacent vertebrae with a prosthesis, a so-called cage.

That is, the prosthesis is to restore the vertebral function by restoring the original distance between two adjacent vertebral bodies, the original height of the intervertebral disc.

As a surgical method for inserting such a prosthesis between the vertebrae, an anterior lumbar interbody fusion (ALIF) that opens the abdomen and inserts the prosthesis in front of the spine, a latent lumbar interbody fusion (LLIF) that inserts the prosthesis through the flanks, etc. Transforaminal Lumbar Interbody Fusion (TLIF) inserts the prosthesis diagonally at a distance of 30 to 40 mm from the center to the back, and Interior Lumbar Interbody Fusion (PLIF) inserts the prosthesis from the back.

Looking at the conventional TLIF treatment method with reference to Figure 11, as shown in Figure 11 (a) one side of the prosthesis (3) is first inserted in a diagonal direction through the back (R) of the human body and the vertebrae (5) and After being located between the vertebrae 5, the front surface of the inserted prosthetic material 3 is disposed to face toward the abdomen F of the human body, and the insertion of the prosthetic material 3 is completed as shown in FIG.

Here, an impactor (4), which is an auxiliary device, is required to direct the front side of the prosthetic material 3 toward the abdomen F of the human body, and the force is applied to the other side of the prosthetic material 3 by the impactor 4. By applying the prosthesis (3) is rotated to face the human body (F) side.

At this time, according to the conventional TLIF treatment method, the position of the prosthetic member is easily influenced by the operator's skill, and there is a problem that the prosthetic member 3 is not easily positioned between the vertebrae 5 and the prosthetic member ( If 3) is not exactly located between the vertebrae (5) there is a problem falling surgical effect.

Invented from the above point of view, such as "less invasive surgical system and method" (hereinafter, 'prior art') of the Patent Publication No. 10-2007-0109977.

However, this prior art has a clear limitation in stably mounting a tool such as a retractor on the part such as vertebrae during surgery, given the complicated vertebral shape of the subject.

That is, in the prior art, the end of the retractor does not come into close contact with a part such as the vertebrae, and during the procedure, the operator accidentally touches a rupture or fluid vessel such as a urethra or an artery, or ruptures, or between the vertebrae and the adjacent vertebrae. There was a risk of making fatal mistakes such as touching and damaging the ligaments.

The present invention is designed to improve the above problems, to provide a retractor assembly for minimally invasive procedures to enable a stable and reliable procedure without touching sensitive and dangerous areas such as bodily fluids, blood vessels or ligaments, etc. It is for.

In order to achieve the above object, the present invention is inserted through the opening (opening) of the subject, the body through the both ends of the channel (channel) is formed; And a tip unit provided at a distal end of the main body and having an end edge corresponding to an outline shape of a bone of an operator, which is an object to be treated, for a minimally invasive surgical retractor assembly. Can be.

Here, the main body is inclined at a predetermined angle with respect to the bone and the body of the subject in the state in which the end edge of the tip unit is in contact with the bone.

In this case, the tip unit is used for Oblique Lateral Interbody Fusion Techniques (OLIF), and the bone of the subject is a vertebral bone.

The opening is formed in the abdomen of the subject, and the tip unit is inserted from the abdomen to incline at an angle with respect to the abdomen of the subject.

The tip unit may be integrally formed with the main body.

And, the tip unit is characterized in that the detachable coupling to the body.

The main body and the tip unit form a pair of divided parts divided along the forming direction of the channel, and the pair of divided parts have a portion corresponding to the tip unit of the pair of divided parts. In the state inserted into the opening of the subject is characterized in that the mutually spaced or close to each other in the direction perpendicular to the formation direction of the channel.

The tip unit may have a long extension having a first outer side surface extending from the one end edge of the main body to a first length and a second length shorter than the first length from the other end edge of the main body. And a short extension having a second outer surface, wherein an end edge of the long extension and an end edge of the short extension are interconnected to correspond to the outer shape of the bone.

The minimally invasive surgical retractor assembly includes an inspection incision groove formed in an arc shape inclined with respect to an imaginary line passing through the center of the channel over the main body and the tip unit with respect to the other edge of the front end of the main body. It further comprises.

The tip unit includes a long extension having a first outer side surface extending from the one side edge of the main body to a first length, and the first outer side has the center of the channel from the one side edge of the main body. It is characterized in that it is formed to be inclined extending gradually closer to the penetrating virtual line.

The minimum invasive retractor assembly may be formed by dividing the main body and the tip unit into two parts along the direction of formation of the channel, and having a pair of arc-shaped cross sections viewed in a direction orthogonal to the direction of formation of the channel. The pair of partitions such that the partitions and the portions corresponding to the tip units of the pair of partitions can be spaced apart or close to each other in a direction orthogonal to the direction of formation of the channel while being inserted into the opening of the subject. Characterized in that it further comprises a gap retaining rod inserted through each inner circumferential surface.

The minimally invasive retractor assembly includes an insertion channel formed on an inner circumferential surface of each of the pair of divisions to face each other, and a reinforcing rib penetrating along the forming direction of the reinforcing rib, wherein the spacing rod is inserted. It characterized in that it further comprises.

In addition, the retractor assembly for minimally invasive procedures is formed in each of the pair of partitions, and forms a portion corresponding to the tip unit of the pair of partitions, and the main body of the pair of partitions. A half-length extension having a first outer surface extending from the one end edge of the portion corresponding to the first length and a second length shorter than the first length from the other end edge of the portion corresponding to the body; And a half length extension portion having a second outer surface, wherein the half length extension portion and the half length extension portion are interconnected in a state in which the inner circumferential surface of each of the pair of partitions faces each other to form an outer shape of the bone. It is characterized by the corresponding.

According to the present invention of the above configuration, the following effects can be achieved.

First of all, the present invention includes a main body and a tip unit, and the tip edge of the tip unit is formed to correspond to the outer shape of the bone of the subject, which is the target site of the treatment, so that the fluid flows sensitive and dangerous such as a fluid tube, blood vessel, or ligament. Stable and reliable procedure is possible without touching the site.

In particular, the present invention is suitable for Oblique Lateral Interbody Fusion Techniques (OLIF), and the bones of the subjects can be applied to bones of unspecified areas, as well as the spine where the OLIF procedure is mainly performed as described above. It may be bone.

And, the present invention will be able to simplify the structure by forming the body and the tip unit integrally.

In addition, the present invention may be made to be detachable to the main body and the tip unit, it can be applied to various types of minimally invasive procedures corresponding to the outer shape of the bones of various subjects, including the spine.

In addition, the present invention allows the main body and the tip unit to be formed into a pair of divided parts along the direction in which the channel inside the main body is formed, thereby reducing the cross-sectional area of the channel so that various surgical instruments such as complicated surgery, endoscope, or impactor are not interrupted. Of course, it can be made variable.

1 is a cross-sectional conceptual view showing a surgical procedure according to oblique lateral interbody fusion techniques (OLIF) using a retractor assembly for minimally invasive procedures according to an embodiment of the present invention

Figure 2 is a perspective view showing the overall structure of the retractor assembly for minimally invasive procedures according to an embodiment of the present invention

Figure 3 is a side conceptual view showing the overall structure of the retractor assembly for minimally invasive procedures according to an embodiment of the present invention

Figure 4 is a perspective view showing a part of the structure of the retractor assembly for minimally invasive procedures according to another embodiment of the present invention

Figure 5 is a side view as viewed from the outer side of the retractor assembly for minimally invasive procedures according to another embodiment of the present invention

Figure 6 is a perspective view of the retractor assembly for minimally invasive procedures according to another embodiment of the present invention from a different point of view

7 and 8 are perspective views showing the operation process according to the Oblique Lateral Interbody Fusion Techniques (OLIF) using a retractor assembly for minimally invasive procedures according to another embodiment of the present invention

9 and 10 is a cross-sectional conceptual view showing a process of inserting the prosthetic material using the retractor assembly for minimally invasive procedures according to an embodiment of the present invention

11 is a cross-sectional conceptual view showing a procedure according to the conventional transforaminal lumbar interbody fusion (TLIF)

Advantages and features of the present invention, and methods for achieving them will be apparent with reference to the embodiments described below in detail with the accompanying drawings.

However, the present invention is not limited to the embodiments disclosed below, but may be implemented in various different forms.

In this specification, the embodiments are provided so that the disclosure of the present invention may be completed, and a person of ordinary skill in the art may completely notify the scope of the present invention.

And the present invention is only defined by the scope of the claims.

Thus, in some embodiments, well known components, well known operations and well known techniques are not described in detail in order to avoid obscuring the present invention.

In addition, the same reference numerals throughout the specification refer to the same components, and the terminology (discussed) used herein are for describing the embodiments and are not intended to limit the invention.

As used herein, the singular forms "a", "an" and "the" include plural unless the context clearly dictates otherwise, and the elements and acts referred to as 'comprises' or 'do' not exclude the presence or addition of one or more other components and acts. .

Unless otherwise defined, all terms used in the present specification (including technical and scientific terms) may be used as meanings that can be commonly understood by those skilled in the art.

In addition, the terms defined in the commonly used dictionary are not ideally or excessively interpreted unless they are defined.

Hereinafter, with reference to the accompanying drawings will be described a preferred embodiment of the present invention.

1 is a cross-sectional conceptual view illustrating a surgical procedure according to oblique lateral interbody fusion techniques (OLIF) using a retractor assembly for minimally invasive procedures according to an embodiment of the present invention.

And, Figure 2 is a perspective view showing the overall structure of the minimally invasive surgical retractor assembly according to an embodiment of the present invention, Figure 3 is a whole structure of the minimum invasive surgical retractor assembly according to an embodiment of the present invention The side conceptual diagram shown.

The present invention is inserted through the opening (not shown) of the subject as shown, the main body 10 of the both ends through the channel (10c, channel) formed therein, and the distal end of the main body 10 It can be seen that the end edge 21 is provided in the structure including a tip unit 20 formed to correspond to the outer shape of the bone 50 of the subject to be treated.

Therefore, the present invention is provided with a main body 10 and the tip unit 20, so that the end edge 21 of the tip unit 20 is formed so as to correspond to the outer shape of the bone 50 of the subject to be the treatment target site In addition, a stable and reliable procedure can be performed without touching a sensitive and dangerous area such as a vascular tube such as an urethral canal (uc), a blood vessel such as an artery (ar), or a ligament (ga).

The present invention is applicable to the embodiment as described above, it is of course also possible to apply the following various embodiments.

With the end edge 21 of the tip unit 20 in contact with the bone 50, the body 10 is inclined at an angle with respect to the bone 50 and the body of the subject.

That is, the tip unit 20 is suitable for Oblique Lateral Interbody Fusion Techniques (OLIF), and the bone 50 of the subject may be applied to bones of an unspecified region, as described above. It may be the vertebral bone 50 in which the OLIF procedure is performed.

In other words, the opening of the subject is formed in the abdomen of the subject, and the tip unit 20 is inserted from the abdomen so that the procedure may be performed at an angle with respect to the abdomen of the subject.

And, the present invention will be able to simplify the structure by integrally forming the tip unit 20 and the main body 10.

In addition, the present invention may be manufactured so that the tip unit 20 and the main body 10 can be detachably, so as to correspond to the outer shape of the bones of the various subjects, including the vertebrae 50 to be applied to various types of minimally invasive procedures Of course you can.

Meanwhile, referring to FIGS. 2 and 3, the tip unit 20 has a long extension part 22a having a first outer surface 24a extending from the one end edge of the main body 10 to the first length L1. And a short extension portion 22b having a second outer surface 24b extending from the other end edge of the main body 10 to a second length L2 shorter than the first length L1. Can be applied.

Accordingly, the end edge of the long extension portion 22a and the end edge of the short extension portion 22b are interconnected to correspond to the outer shape of the bone 50 (see FIG. 1).

In addition, the first outer surface 24a passes through the center of the channel 10c from the one side edge of the front end of the main body 10 so as to smoothly reach the outside of the bone 50 through the opening of the subject. It is formed to be inclined to extend gradually toward the ().

In addition, the present invention is to insert the endoscope as shown in the arteries (ar (see Fig. 1 below) to determine the position of the blood vessels, such as to be able to perform the procedure, the body 10 relative to the other edge of the front end of the body 10 It is preferable to further include a check cutting groove 23 formed in an arc shape inclined with respect to the imaginary line v passing through the center of the channel (10c) over the tip unit 20 and the tip unit (20).

On the other hand, the main body 10 and the tip unit 20 is applied to the embodiment of the structure to form a pair of divided parts (15a, 15b) divided into two along the forming direction of the channel (10c) as shown in Figs. You may.

For reference, Figure 4 is a perspective view showing a part of the structure of the retractor assembly for minimally invasive procedures according to another embodiment of the present invention, Figure 5 is an outer surface of the retractor assembly for minimally invasive procedures according to another embodiment of the present invention 6 is a side view, and FIG. 6 is a perspective view of the retractor assembly for minimally invasive procedure according to another embodiment of the present invention, viewed from a different point of view.

7 and 8 are perspective views illustrating a surgical procedure according to oblique lateral interbody fusion techniques (OLIF) using a retractor assembly for minimally invasive procedures according to another embodiment of the present invention.

That is, the pair of

partitions

15a and 15b are channels 10c in a state in which a portion of the pair of

partitions

15a and 15b corresponding to the tip unit 20 is inserted into the opening of the subject. It can be spaced apart or close to each other in the direction orthogonal to the formation direction of.

Here, the pair of divided

bodies

15a and 15b are formed in an arc shape in cross section viewed from the direction orthogonal to the formation direction of the channel 10c.

At this time, the pair of divided

parts

15a and 15b are formed in each of the pair of divided

parts

15a and 15b and form portions corresponding to the tip unit 20 among the pair of divided

parts

15a and 15b. And a half-length extension portion 22ah having a first outer side surface 24a extending from the one end edge of the portion of the pair of

split bodies

15a and 15b corresponding to the main body 10 to the first length L1. More).

The pair of

split bodies

15a and 15b extend from the other end edge of the portion corresponding to the main body 10 to a second length L2 shorter than the first length L1. It further includes a half end extension (22bh) having.

Therefore, the half-long extension part 22ah and the half-end extension part 22bh are interconnected in the state where the inner circumferential surface of each of the pair of

divisions

15a and 15b is disposed to face and correspond to the outer shape of the bone 50. Will be.

In addition, the space | interval holding rib 19 may be formed along the above-mentioned arc-shaped edge part in the part of the above-mentioned arc shape, ie, the part corresponding to the main body 10 among the pair of

divisions

15a and 15b.

That is, the spacing rib 19 varies the cross-sectional area of the channel 10c so that various surgical instruments such as an endoscope (not shown below) or an impactor 40 (see FIGS. 10 and 11) do not interfere in complicated surgery. It is intended to help you do it.

Meanwhile, the present invention is orthogonal to the direction in which the channel 10c is formed in a state in which a portion corresponding to the tip unit 20 of the pair of

split bodies

15a and 15b is inserted into the opening of the subject as shown in FIGS. 7 and 8. In order to be spaced apart or close to each other in the direction, it may be further provided with a spacing holding rod 16 inserted through the inner circumferential surface of each of the pair of

partitions

15a and 15b.

Here, the present invention is formed on the inner circumferential surface of each of the pair of

partitions

15a and 15b for the detachable coupling of the spacing retaining rod 16 to face each other along the direction of formation of the reinforcing ribs 17 and the reinforcing ribs. It is preferred to further include an insertion channel 18 through which the spacing rod 16 is inserted.

Therefore, the operator inserts the pair of

partitions

15a and 15b through the opening of the subject, and holds the gap retaining rods 16 and appropriately in the direction in which the pair of the

partitions

15a and 15b are spaced apart or close to each other. The endoscope is inserted through the impactor 40 or the check incision groove 23 through the cross-sectional area of the variable channel 10c while being displaced to determine the position of blood vessels or important organs, and to operate without touching the corresponding area. .

Therefore, the process of inserting the prosthesis material 30 using the minimally invasive surgical retractor assembly according to various embodiments of the present invention shown in FIGS. 1 to 8 will be described below with reference to FIGS. 9 and 10. same.

First, the operator forms an opening in the abdomen of the subject and inserts through the opening from the end edge 21 of the tip unit 20 of the main body 10 by the procedure according to OLIF, and inserts the end edge 21 into the vertebrae 50 Close contact to the outer shape of).

Thereafter, the operator uses the impactor 40 to transfer the prosthesis 30 through the channel 10c (see FIGS. 2 and 3 below) between the vertebrae 50 and the adjacent vertebrae 50 as shown in FIG. 9. Place it in space.

Next, the practitioner uses the impactor 40 or a separately inserted tool (hereinafter, not shown) in the desired direction as shown in FIG. 10 in the space between the vertebrae 50 and the adjacent vertebrae 50 as shown in FIG. 10. Just sort by.

At this time, the operator may perform the procedure while grasping the position of the main blood vessels such as the artery (ar) by the endoscope introduced through the channel (10c).

In other words, the shape of the end edge 21 of the tip unit 20 and the shape of the inspection incision groove 23 refer to FIG. 1 again, such as a human body such as a ligament (ga) or a urethra (uc) and an artery (ar). It is a technical means for a series of procedures to be performed in a state in which a stable contact with the outer shape of the vertebrae 50 without almost touching the main tissue of the.

As described above, the present invention aims to provide a retractor assembly for minimally invasive procedures that enables a stable and reliable procedure without touching sensitive and dangerous areas such as a bodily fluid tube, a blood vessel or a ligament through which fluid flows. Able to know.

In addition, many modifications and applications are also possible to those skilled in the art within the scope of the basic technical idea of the present invention.

Claims

A body penetrating through an opening of the operator and having a channel formed therein; And

The retractor assembly for minimally invasive procedures, characterized in that provided in the distal end of the main body, the end edge includes a tip unit formed to correspond to the outer shape of the bone of the subject to be treated.
The method according to claim 1,

The retractor assembly for minimally invasive procedures, characterized in that the main body is inclined at an angle with respect to the bone and the body of the subject with the end edge of the tip unit in contact with the bone.
The method according to claim 1,

And the tip unit is for oblique lateral interbody fusion techniques (OLIF), wherein the bone of the subject is a vertebral bone.
The method according to claim 1,

And the opening is formed in the abdomen of the subject, and the tip unit is inserted from the abdomen to incline at an angle with respect to the abdomen of the subject.
The method according to claim 1,

The tip unit is a retractor assembly for minimally invasive procedures, characterized in that formed integrally with the body.
The method according to claim 1,

The tip unit is a retractor assembly for minimally invasive procedures, characterized in that the detachable coupling to the body.
The method according to claim 1,

The main body and the tip unit form a pair of divided parts divided along the forming direction of the channel, and the pair of divided parts have a portion corresponding to the tip unit of the pair of divided parts of the subject. The retractor assembly for minimally invasive procedures, characterized in that spaced apart or close to each other in the direction orthogonal to the direction of formation of the channel in the state of being inserted into the opening.
The method according to claim 1,

The tip unit,

A long extension having a first outer side surface extending from the one end edge of the main body to a first length;

A short extension having a second outer surface extending from the other leading edge of the body to a second length shorter than the first length,

Retractor assembly for minimally invasive procedures, characterized in that the end edge of the long extension and the end edge of the short extension is interconnected to correspond to the outer shape of the bone.
The method according to claim 1,

The minimally invasive surgical retractor assembly,

Minimally invasive surgical procedure characterized in that it further comprises a check incision groove cut in an arc shape inclined with respect to the imaginary line passing through the center of the channel across the main body and the tip unit with respect to the other edge of the front end. Tractor assembly.
The method according to claim 1,

The tip unit,

A long extension having a first outer surface extending from the one end edge of the main body to a first length,

The first outer surface is a retractor assembly for minimally invasive surgery, characterized in that the inclined extending from the leading edge of the main body toward the imaginary line passing through the center gradually closer.
The method according to claim 1,

The minimally invasive surgical retractor assembly,

A pair of dividing bodies formed by dividing the main body and the tip unit along a forming direction of the channel, the cross section viewed in a direction orthogonal to the forming direction of the channel, and having an arc shape;

The inner circumferential surface of each of the pair of partitions may be spaced apart from or close to each other in a direction orthogonal to the formation direction of the channel in a state where a portion corresponding to the tip unit of the pair of partitions is inserted into the opening of the subject. Retractor assembly for minimally invasive procedures, characterized in that it further comprises a spacing rod inserted through.
The method according to claim 11,

The minimally invasive surgical retractor assembly,

Reinforcing ribs formed on the inner circumferential surface of each of the pair of divided bodies to face each other,

Retractor assembly for the minimally invasive procedure characterized in that it further comprises an insertion channel penetrating along the forming direction of the reinforcing rib, the spacing rod is inserted.
The method according to claim 11,

The minimally invasive surgical retractor assembly,

A first length formed on each of the pair of partitions and forming a portion corresponding to the tip unit of the pair of partitions, and having a first length from one end edge of the portion of the pair of partitions corresponding to the main body; A half-length extension with a first outer surface extending to

And a half end extension having a second outer side surface extending from the other end edge of the portion corresponding to the main body to a second length shorter than the first length,

The half length extension part and the half length extension part are interconnected in a state where the inner circumferential surface of each of the pair of partitions is disposed to face the outer shape of the bone, minimally invasive procedure retractor assembly.