ES2334622B1 - DEVICE FOR ELIMINATION OF OSEO FABRIC IN ENDOSCOPIC OPERATIONS. - Google Patents
DEVICE FOR ELIMINATION OF OSEO FABRIC IN ENDOSCOPIC OPERATIONS. Download PDFInfo
- Publication number
- ES2334622B1 ES2334622B1 ES200801552A ES200801552A ES2334622B1 ES 2334622 B1 ES2334622 B1 ES 2334622B1 ES 200801552 A ES200801552 A ES 200801552A ES 200801552 A ES200801552 A ES 200801552A ES 2334622 B1 ES2334622 B1 ES 2334622B1
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- Prior art keywords
- tool
- cutting
- distal
- cutting tool
- probe
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- Withdrawn - After Issue
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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, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1613—Component parts
- A61B17/1615—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1613—Component parts
- A61B17/1615—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
- A61B17/1617—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material with mobile or detachable parts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
- A61B17/1671—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the spine
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
- A61B17/32002—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1637—Hollow drills or saws producing a curved cut, e.g. cylindrical
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/00296—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means mounted on an endoscope
Abstract
Dispositivo para eliminación de tejido óseo en operaciones endoscópicas, del tipo que comprende una herramienta de corte concéntrica y exterior a una sonda alargada, caracterizado porque dicha herramienta presenta una zona distal de corte de geometría cónica, presentando la superficie cónica distal un conjunto de filos de corte lateral.Device for bone tissue removal in endoscopic operations, of the type comprising a tool for concentric and external cut to an elongated probe, characterized because said tool has a distal cutting area of conical geometry, presenting the distal conical surface a set of lateral cutting edges.
Description
Dispositivo para eliminación de tejido óseo en operaciones endoscópicas.Device for bone tissue removal in endoscopic operations
La presente invención hace referencia a un dispositivo para la eliminación de tejido en operaciones endoscópicas, en especial para la eliminación de tejido óseo.The present invention refers to a tissue removal device in operations Endoscopic, especially for the removal of bone tissue.
La presente invención es de especial utilidad en la realización de operaciones endoscópicas para tratamiento de hernias discales, si bien la invención no queda limitada necesariamente a dicha finalidad.The present invention is especially useful. in performing endoscopic operations for the treatment of herniated discs, although the invention is not limited necessarily for that purpose.
Resultan sobradamente conocidas las técnicas y dispositivos endoscópicos para el tratamiento de hernias discales de columna. En dichas operaciones, tras realizar un corte en la piel del paciente, se introduce inicialmente un primer elemento alargado con punta cónica roma cuyo objetivo es adaptar los tejidos blandos hasta las proximidades del disco dañado que hay que reparar. Una vez introducido este primer elemento alargado, se introduce una cánula fina cuyo diámetro interior coincide con el diámetro exterior del primer elemento alargado. El diámetro exterior de dicha cánula puede variar entre 2 y 10 mm, siendo más habituales las de diámetro de 6 mm. Dicha cánula es roma y puede presentar diversas geometrías en su extremo distal, si bien en general el borde distal presenta un desarrollo generalmente oblicuo con respecto al eje de la cánula para permitir una mejor visión de la zona de trabajo. Tras la introducción de la cánula, se retira el primer elemento alargado con lo cual queda un canal abierto de acceso a la zona discal lesionada en el que se introduce una sonda óptica que ajusta en dicho canal, y que contiene a su vez canales para agua a presión para limpieza-succión de elementos, y, en algunos modelos, canales de trabajo para diversos aparatos de tratamiento o manipulación del tejido.Techniques and techniques are well known. endoscopic devices for the treatment of herniated discs of column. In these operations, after making a cut in the patient's skin, a first element is initially introduced elongated with blunt conical tip whose objective is to adapt the fabrics soft to the vicinity of the damaged disk that needs to be repair. Once this first elongated element has been introduced, it introduces a fine cannula whose inner diameter coincides with the outer diameter of the first elongated element. The diameter outside of said cannula can vary between 2 and 10 mm, being more usual 6mm diameter. This cannula is blunt and can present various geometries at its distal end, although in In general, the distal edge presents a generally oblique development with respect to the axis of the cannula to allow a better view of The work area. After the introduction of the cannula, the first elongated element with which an open channel of access to the injured disc area in which a probe is inserted optics that adjust in said channel, and that in turn contain channels for pressurized water for cleaning-suction of elements, and, in some models, working channels for various tissue treatment or manipulation devices.
Sin embargo, se presenta un problema cuando aparece una zona de crecimiento o malformación ósea que separa la zona discal de la punta de la cánula, o bien interfiere en dicha área de trabajo. En algunos de estos casos, por lo demás frecuentes, resulta necesario utilizar una herramienta cortante para cortar o limar hueso, de cara a obtener acceso a la zona a tratar.However, a problem occurs when an area of bone growth or malformation appears that separates the disc area of the tip of the cannula, or interferes with said work area. In some of these cases, otherwise frequent, it is necessary to use a cutting tool to cut or file bone, in order to gain access to the area try.
En estos casos, las técnicas hasta ahora conocidas aportan tres posibles soluciones. La primera consiste en una herramienta de corte de dimensiones tales que es capaz de introducirse por un canal de trabajo de la sonda óptica. Esta solución permite al usuario cortar tejido óseo manteniendo un control visual de sus operaciones. Sin embargo, esto presenta el problema de que la herramienta resulta necesariamente de diámetro muy reducido (diámetro máximo de 3,5 mm) y las operaciones de eliminación de tejido óseo pueden requerir un tiempo excesivo, que podría incluso redundar en perjuicio para el paciente. Una segunda solución conocida consiste en retirar la sonda óptica y utilizar una herramienta de corte de mayor diámetro en su lugar. Esto presenta el problema de que obliga al usuario a realizar la operación sin disponer de visión directa de los tejidos blandos presentes, con el consiguiente peligro de dañar tejido nervioso perteneciente a la zona epidural.In these cases, the techniques so far known provide three possible solutions. The first consists of a cutting tool of dimensions such that it is capable of be introduced through a working channel of the optical probe. This solution allows the user to cut bone tissue while maintaining a Visual control of your operations. However, this presents the problem that the tool is necessarily of diameter very small (maximum diameter of 3.5 mm) and the operations of Bone tissue removal may require excessive time, which It could even be detrimental to the patient. A second known solution is to remove the optical probe and use a cutting tool with a larger diameter in place. This presents the problem that forces the user to perform the operation without having direct vision of soft tissues present, with the consequent danger of damaging nerve tissue belonging to the epidural zone.
De acuerdo con la técnica conocida, la herramienta de corte es habitualmente un cilindro cuyo extremo distal es perpendicular al eje del cilindro. Dicho extremo distal consiste en una zona de corte habitualmente aserrada, variando fundamentalmente el diámetro de la herramienta para cada uno de los dos tipos de solución citados.According to the known technique, the cutting tool is usually a cylinder whose end distal is perpendicular to the axis of the cylinder. Said distal end It consists of a usually sawn cutting area, varying fundamentally the diameter of the tool for each of the Two types of solution cited.
En concreto, la presente invención consiste en un dispositivo para la eliminación de tejido óseo en operaciones endoscópicas, del tipo que comprende una herramienta de corte concéntrica y exterior a una sonda alargada (en general, una guía). De manera característica para la invención, la herramienta de corte presenta una zona distal de corte de geometría cónica, presentando la superficie cónica distal un conjunto de filos de corte lateral, es decir, de corte a derechas o a izquierdas.Specifically, the present invention consists of a device for the removal of bone tissue in operations endoscopic, of the type comprising a cutting tool concentric and external to an elongated probe (in general, a guide). Characteristically for the invention, the tool for cut presents a distal cut zone of conical geometry, presenting the distal conical surface a set of edges of lateral cut, that is, cut to the right or left.
El nuevo dispositivo de corte presenta una doble ventaja con respecto a los dispositivos antes conocidos. En primer lugar su zona de corte cónica permite un corte progresivo de la zona a eliminar. Además, al presentar un corte lateral (a izquierdas o a derechas), lo que se consigue es un perfecto control del corte de la herramienta, que sólo cortará cuando se haga girar la herramienta en el sentido que provoca el corte. De esta manera se consigue aumentar de manera conjunta tanto la capacidad de corte como la seguridad con respecto a lo anteriormente conocido.The new cutting device features a double advantage over previously known devices. In first its tapered cutting area allows a progressive cutting of The area to be removed. In addition, when presenting a lateral cut (a left or right), what you get is perfect control of the tool cut, which will only cut when it is rotated the tool in the direction that causes the cut. In this way it is possible to jointly increase both the cutting capacity as security with respect to the previously known.
Para minimizar la posibilidad de daño no deseado a tejidos, la zona distal cónica será redondeada en su punta o parte más distal.To minimize the possibility of damage do not desired to tissues, the conical distal area will be rounded in its tip or most distal part.
En realizaciones preferentes, los filos de la herramienta de corte serán paralelos entre sí, más preferentemente de desarrollo helicoidal sobre la superficie cónica, dejando surcos para la recepción del tejido eliminado.In preferred embodiments, the edges of the cutting tool will be parallel to each other, more preferably helical development on the conical surface, leaving grooves for the reception of the removed tissue.
Si bien en una realización más sencilla el dispositivo está compuesto de una sonda y una herramienta de corte, ésta podrá ser complementada con otros dispositivos de tipo conocido. Por otro lado, el dispositivo podrá comprender más de una herramienta de corte con las características antes descritas. En concreto, el dispositivo podrá comprender una segunda herramienta de corte de diámetro mayor que la primera herramienta de corte. En este caso, de manera preferente, la conicidad de la primera herramienta de corte será menor que la conicidad de la segunda. Es decir, la superficie cónica de la primera herramienta presentará un ángulo con respecto al eje central inferior al de la segunda herramienta. Mediante esta disposición se consigue zonas de corte progresivamente mayores, sin necesidad de incrementar en demasía el avance de la zona eliminada.While in a simpler embodiment the device is composed of a probe and a cutting tool, This can be complemented with other type devices known. On the other hand, the device may comprise more than one cutting tool with the characteristics described above. In specifically, the device may comprise a second tool cutting diameter larger than the first cutting tool. In this case, preferably, the taper of the first Cutting tool will be less than the taper of the second. Is that is, the conical surface of the first tool will present a angle with respect to the central axis lower than the second tool. Through this arrangement, cutting areas are achieved. progressively older, without the need to increase the advance of the eliminated zone.
Para una mejor comprensión de la invención, se adjunta a título de ejemplo explicativo pero no limitativo, unos dibujos de unas realizaciones de la presente invención.For a better understanding of the invention, attached by way of explanatory example but not limiting, some drawings of embodiments of the present invention.
La figura 1 es una vista en perspectiva de una representación esquemática de una sonda utilizada en operaciones de hernia discal.Figure 1 is a perspective view of a schematic representation of a probe used in operations of herniated disc
La figura 2 es una vista en alzado frontal en la que se puede ver el extremo distal de dicha sonda.Figure 2 is a front elevation view in which can be seen the distal end of said probe.
La figura 3 es una vista en perspectiva, parcialmente seccionada, de una herramienta de corte para utilización conjunta con la sonda de las figuras 1 y 2.Figure 3 is a perspective view, partially sectioned, of a cutting tool for joint use with the probe of figures 1 and 2.
La figura 4 es una vista en alzado frontal en la que se observa el extremo distal de la citada herramienta de corte.Figure 4 is a front elevation view in which is observed the distal end of the mentioned tool of cut.
La figura 5 es una vista en perspectiva de la herramienta de las figuras 3 y 4.Figure 5 is a perspective view of the tool of figures 3 and 4.
La figura 6 es una vista en perspectiva, parcialmente seccionada, de una segunda herramienta de corte para utilización conjunta con la sonda de las figuras 1 y 2 y la herramienta de corte de las figuras 3 a 5.Figure 6 is a perspective view, partially sectioned, of a second cutting tool for joint use with the probe of figures 1 and 2 and the cutting tool of figures 3 to 5.
La figura 7 es una vista en alzado frontal en la que se observa el extremo distal de la citada herramienta de corte.Figure 7 is a front elevation view in which is observed the distal end of the mentioned tool of cut.
La figura 8 es una vista en perspectiva de la segunda herramienta de corte mostrada en las figuras 6 y 7.Figure 8 is a perspective view of the second cutting tool shown in figures 6 and 7.
La figura 9 muestra la sonda y una herramienta de corte en disposición de uso.Figure 9 shows the probe and a tool of cut in disposition of use.
La figura 10 muestra la sonda y la segunda herramienta de corte en disposición de uso.Figure 10 shows the probe and the second cutting tool available for use.
En las figuras 1 a 10 se ha mostrado una posible realización del dispositivo según la presente invención, únicamente de manera esquemática y en referencia a sus partes más significativas.Figures 1 to 10 show a possible embodiment of the device according to the present invention, only schematically and in reference to its parts more significant.
Otros elementos del dispositivo pueden ser realizados según técnicas sobradamente conocidas en el sector. A modo de ejemplo, se hace expresa mención al documento ES2279733, del mismo inventor.Other elements of the device can be made according to techniques well known in the sector. TO As an example, express mention is made of document ES2279733, from the same inventor.
El dispositivo mostrado está compuesto de una sonda (1) que dispone, al menos, de un canal (11), por ejemplo, un canal de guía para fiador (11) y/o un canal de infiltración (111), o ambas cosas, y una primera (2) y una segunda (3) herramientas de corte concéntricas y exteriores a la sonda (1). Cada herramienta de corte (2), (3) dispone de un extremo distal (21), (31) con forma cónica (más exactamente troncocónica) y un orificio interior (23), que rodea, en uso, a la sonda (1).The device shown is composed of a probe (1) that has at least one channel (11), for example, a guide channel for guarantor (11) and / or an infiltration channel (111), or both, and a first (2) and a second (3) tools of concentric cutting and external to the probe (1). Each tool of cut (2), (3) has a distal end (21), (31) shaped conical (more exactly truncated conical) and an inner hole (23), surrounding, in use, the probe (1).
Las zonas cónicas (21), (31), (33) presentan numerosos filos paralelos entre sí y de desarrollo helicoidal. La geometría de los filos (ángulos de ataque, filo e incidencia) son tales que resulta de corte lateral (corte a izquierdas o corte a derechas), según técnicas conocidas del mundo de la fresa industrial. De esta manera, la herramienta efectúa corte únicamente cuando es girada en su determinado sentido.The conical zones (21), (31), (33) present numerous edges parallel to each other and helical development. The Edge geometry (angles of attack, edge and incidence) are such that it results from lateral cut (left cut or cut to right), according to known techniques of the strawberry world industrial. In this way, the tool cuts only when it is turned in its certain direction.
Como se observa en las figuras, la segunda herramienta presenta un diámetro exterior mayor, así como una conicidad mayor.As seen in the figures, the second tool has a larger outside diameter, as well as a greater conicity
La punta más distal (22), (32) de las herramientas de corte (2), (3) es redondeada.The most distal tip (22), (32) of the Cutting tools (2), (3) is rounded.
En uso, se procede a introducir en primer lugar la primera herramienta de corte deslizándola a lo largo de la sonda, mediante un movimiento lineal, sin giro en el sentido de corte de la herramienta. La forma cónica favorece la penetración sin daño a los tejidos blandos. Una vez contactada la zona ósea a eliminar, se procede a girar la herramienta en el sentido de corte.In use, we proceed to introduce first the first cutting tool sliding it along the probe, by linear movement, without turning in the direction of tool cutting. The conical shape favors penetration No damage to soft tissues. Once the bone area has been contacted delete, the tool is rotated in the direction of cut.
Si la zona a eliminar es de suficiente entidad, se procede a introducir una segunda herramienta de corte, de mayor diámetro, y así sucesivamente en caso de necesitar destruir zonas más importantes.If the area to be removed is of sufficient entity, a second cutting tool is introduced, of greater diameter, and so on in case you need to destroy areas more important.
Si bien la invención se ha descrito con respecto a ejemplos de realizaciones preferentes, éstos no se deben considerar limitativos de la invención, que se definirá por la interpretación más amplia de las siguientes reivindicaciones.While the invention has been described with regarding examples of preferred embodiments, these should not be consider limiting the invention, which will be defined by the broader interpretation of the following claims.
Claims (7)
Priority Applications (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| ES200801552A ES2334622B1 (en) | 2008-05-26 | 2008-05-26 | DEVICE FOR ELIMINATION OF OSEO FABRIC IN ENDOSCOPIC OPERATIONS. |
| PCT/EP2009/003672 WO2009152919A1 (en) | 2008-05-26 | 2009-05-25 | Device for removing bone tissue during endoscopic surgery |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| ES200801552A ES2334622B1 (en) | 2008-05-26 | 2008-05-26 | DEVICE FOR ELIMINATION OF OSEO FABRIC IN ENDOSCOPIC OPERATIONS. |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| ES2334622A1 ES2334622A1 (en) | 2010-03-12 |
| ES2334622B1 true ES2334622B1 (en) | 2011-01-03 |
Family
ID=41168782
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| ES200801552A Withdrawn - After Issue ES2334622B1 (en) | 2008-05-26 | 2008-05-26 | DEVICE FOR ELIMINATION OF OSEO FABRIC IN ENDOSCOPIC OPERATIONS. |
Country Status (2)
| Country | Link |
|---|---|
| ES (1) | ES2334622B1 (en) |
| WO (1) | WO2009152919A1 (en) |
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| US9486149B2 (en) | 2011-03-10 | 2016-11-08 | Interventional Spine, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
| US9492194B2 (en) | 2011-03-10 | 2016-11-15 | Interventional Spine, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
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| US20040191897A1 (en) * | 2003-03-31 | 2004-09-30 | The Cleveland Clinic Foundation | Apparatus and method for harvesting bone marrow |
| US8784421B2 (en) * | 2004-03-03 | 2014-07-22 | Boston Scientific Scimed, Inc. | Apparatus and methods for removing vertebral bone and disc tissue |
| US20060142775A1 (en) * | 2004-12-29 | 2006-06-29 | Depuy Mitek, Inc. | Surgical tool with cannulated rotary tip |
| EP1741394A1 (en) * | 2005-07-08 | 2007-01-10 | Technische Universiteit Delft | Surgical drill system and surgical drill bit to be used therein |
| US8167899B2 (en) * | 2006-05-04 | 2012-05-01 | Warsaw Orthopedic, Inc. | Retractable stylet and cannula combination |
-
2008
- 2008-05-26 ES ES200801552A patent/ES2334622B1/en not_active Withdrawn - After Issue
-
2009
- 2009-05-25 WO PCT/EP2009/003672 patent/WO2009152919A1/en not_active Application Discontinuation
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US9486149B2 (en) | 2011-03-10 | 2016-11-08 | Interventional Spine, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
| US9492194B2 (en) | 2011-03-10 | 2016-11-15 | Interventional Spine, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
| US9277928B2 (en) | 2013-03-11 | 2016-03-08 | Interventional Spine, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
Also Published As
| Publication number | Publication date |
|---|---|
| WO2009152919A1 (en) | 2009-12-23 |
| ES2334622A1 (en) | 2010-03-12 |
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