WO1997010761A1 - Bistouri pour incision du peritendineum - Google Patents
Bistouri pour incision du peritendineum Download PDFInfo
- Publication number
- WO1997010761A1 WO1997010761A1 PCT/JP1996/002668 JP9602668W WO9710761A1 WO 1997010761 A1 WO1997010761 A1 WO 1997010761A1 JP 9602668 W JP9602668 W JP 9602668W WO 9710761 A1 WO9710761 A1 WO 9710761A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- blade
- incision
- tendon sheath
- shaft
- tendon
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical 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
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
- A61B17/320036—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes adapted for use within the carpal tunnel
Definitions
- the present invention relates to a tendon sheath incision blade used for incising a tendon sheath in a so-called spring finger operation.
- a spring finger is a condition in which the finger cannot bend and stretch smoothly, and when it is bent and stretched, it becomes a pinching shape at a certain angle, and when it is further bent or extended, the finger springs like a spring. is there.
- As a method for treating this spring finger there is a method of incising the tendon sheath by surgery.
- the tendon sheath encloses the flexor tendon, and the finger can be easily bent and stretched by incising the tendon sheath by surgery.
- the tendon sheath incision instrument is used for incising the tendon sheath, and can be suitably used for both percutaneous operation and open operation.
- Figure 10 shows an overall view of a conventional tendon sheath incision
- Figure 11 shows an enlarged view of its blade.
- the tendon sheath incisor is gripped from the grip 10 for firm support by hand, the shaft 12 attached to the grip 10, and the side of the tip of the shaft 12. It comprises a blade portion 14 provided so as to protrude slightly, and a guide portion 16 extending from the lower portion of the blade portion 14 in the same direction as the direction in which the blade portion 14 protrudes.
- the tip of the guide section 16 is inserted between the flexor ⁇ 18 and m 20, and the guide section 1 is placed over the flexor tendon 18. Cut the tendon sheath 20 gradually by sliding 6. In the case of percutaneous surgery, the incision just above the tendon sheath is cut down as small as the tendon sheath incision can be inserted, and the blade section 14 is inserted through this incision to perform the operation. Disclosure of the invention
- the above-mentioned tendon sheath incision guides the cutting direction of the blade 14 using the guide 16 and makes an incision. Therefore, even when the surgical part is not directly visible as in the case of percutaneous surgery, the flexor tendon is used.
- This has the advantage that the operation can be performed safely and reliably without cutting the stomach.
- the tendon sheath incision blade becomes sharp after repeated operations, so it is used after polishing. Repeated power polishing makes the blade thinner and deteriorates its strength, making it unusable. Therefore, a tendon sheath incision blade that is sharp and durable is required.
- An object of the present invention is to provide a tendon sheath incision blade that can be used reliably and safely in a tendon sheath incision operation, can easily perform tendon sheath incision with sharpness, and has higher durability.
- the present invention has the following configuration.
- the blade portion is formed as an arc-shaped blade that rises up smoothly from the guide portion at the section rising from the upper surface of the guide section.
- the blade is formed so as to extend linearly substantially in parallel with the direction of the shaft of the shaft upward from the rising portion.
- the arc-shaped rising part of the blade has a sharp edge, and the part above the blade complements the part cut at the rising part.
- the upper part of the blade is almost parallel to the shaft and has a large inclination angle, so that it is possible to operate without making a large incision in the skin.
- the grip of the grip is improved, and the handleability of the incision sheath is improved.
- the shaft can be advanced to the incision. To facilitate surgery and facilitate surgery.
- the guide portion is formed so as to extend in an L-shape with respect to the shaft, and is formed in a tapered shape, so that it is easy to find a tendon ⁇ portion. It makes you feel sick and secure.
- the upper end surface of the blade is formed as a stepped surface protruding from the side surface of the shaft makes it easier to recognize the position of the blade during surgery.
- the step surface is formed as a flat surface substantially parallel to the guide portion, and that the step surface is formed in a triangular shape with a protruding edge serving as a blade is a corner portion of the step surface.
- FIG. 1 is a side view of a tendon sheath cutting knife according to the present invention.
- FIG. 2 is an explanatory view showing an enlarged blade portion of the tendon sheath incision blade.
- Figure 3 is an illustration showing how to use a tendon sheath incision by percutaneous surgery.
- Figure 4 is an illustration showing how to use a tendon sheath incision by percutaneous surgery.
- Figure 5 is an illustration showing how to use a tendon sheath incision by percutaneous surgery.
- FIG. 6 is an explanatory view showing the inclination angle of the blade of the tendon sheath incision blade.
- Figure 7 is an illustration showing how to use a tendon sheath incision by open surgery.
- Figure 8 is an illustration showing how to use a tendon sheath incision by open surgery.
- Figure 9 is an illustration showing how to use a tendon sheath incision by open surgery.
- Fig. 10 is a side view of a conventional example of a tendon.
- FIG. 11 is an enlarged explanatory view showing a blade portion of a conventional example of a tendon sheath cutting knife.
- Fig. 1 2 is an illustration showing how to use the tendon $ knives.
- FIG. 1 is a side view showing the overall configuration of an embodiment of the tendon sheath cutting knife according to the present invention.
- the overall configuration of the tendon sheath incision of this embodiment is the same as that of the conventional example shown in FIG. 10, except that the grip 10, the shaft 12, the blade 14, and the guide 16. Become.
- the feature of the tendon sheath incision blade of this embodiment lies in the configuration of the blade portion 14 shown in an enlarged manner in FIG. 2, and the blade provided at the tip of the blade portion 14 is cut from the upper surface of the guide portion 16 to the blade portion 14. Is formed in an arc shape over the rising portion of the shaft, and a portion extending upward from the blade formed in the arc shape is formed in a straight line substantially parallel to the axial direction of the shaft 12.
- the tip of the blade portion 14 is a blade over the entire length from the arc-shaped portion to the upper straight portion.
- FIGS. 3 to 5 are explanatory diagrams for explaining the operation of the tendon / bird cutting blade having different blade angles of the blade portion 14.
- FIGS. 3, 4, and 5 show examples where the angles formed by the guide portion 16 and the blade are 80 °, 75 °, and 45 °.
- the figure shows a case of percutaneous surgery, in which the epidermis 22 is incised, and a tendon sheath incision is inserted through the incised portion to cut the tendon sheath 20.
- the skin is cut with a minimum of skin * Incision, so palpate the site of the tendon sheath 20 to be incised, cut the epidermis 20 directly above it slightly, and insert a tendon sheath incisor To
- the guide 16 When incising the tendon sheath 20 with a tendon sheath incisor, the guide 16 is advanced between the flexor tendon 18 and the sheath 20 and the blade 14 is guided while guided by the guide 16. Make an incision as you proceed.
- the guide section 16 enters the tendon sheath 20, it is necessary to open the entrance of the tendon sheath 20 with the guide section 16. I can't do that.
- the tendon can be easily palpated by carefully observing the surface of the skin frost, so that the direction of the guide portion 16 coincides with the running of the tendon, so that the tendon is placed on the surface of the tendon. If you try to move it, you can always enter the entrance. To confirm that Guide 16 actually entered the entrance, lift the tendon sheath sword and feel resistance. Do. Force depending on the thickness of the tendon sheath 20 As shown in the figure, the tendon sheath 20 is incised at the base of the blade 14.
- a method to search for the entrance of the tendon sheath 20 is to insert it into the blade 14 in the same shape as the tendon sheath incision blade. It is advisable to prepare another incision blade without a blade and insert this incision from the incision of the epidermis 20 to search for the entrance of the tendon sheath 20.
- Insert guide 16 at the same position as above to advance the incision of tendon sheath 20.
- the trajectory of the guide 16 is parallel to T.
- the angle ⁇ between the straight line T and the blade is called the inclination angle as shown in the figure, and the maximum value of this inclination angle is 90 ° due to the structure of the tendon sheath incision blade.
- the sharpness becomes poorer as the inclination angle of the blade is larger, that is, as the axis direction of the shaft 12 is closer to the blade in parallel.
- the example shown in FIG. 5 is most sharp, and the example of FIG. 3 is the least sharp.
- Good sharpness means that the blade can maintain its sharpness even if the blade wears out due to its use, and in that sense it has excellent durability.
- the angle of inclination of the blade is large, even if the blade is slightly worn, the sharpness is affected, and in this sense, the durability of the blade is poor.
- the step 14a provided on the upper part of the blade part 14 can be used even when the guide part 16 is hidden under the subcutaneous fat when using a tendon sheath incision blade.
- the depth of the guide part 16 can be determined, and it becomes possible to operate the tendon sheath incision more accurately.
- Figures 7 to 8 show the results of open surgery using tendon sheath incisors with different blade angles. Open surgery is rather wide when the skin can be incised. The soft tissue is developed at wound 24. As shown in FIG. 7, the epidermis 22 is incised, the incision is developed at the incision 2, and the tendon sheath 20 is incised with a tendon sheath incisor. In open surgery, the flexor tendon 18 and the tendon sheath 20 are in direct view, so the guide 16 is inserted into the entrance of the tendon sheath 20 and the tendon sheath 20 is incised with the blade 14.
- the inclination angle of the blade of the blade portion 14 the sharper the blade, and therefore the durability of the blade is improved.
- the position and depth of the blade portion 14 can be ascertained from the position of the corner portion (point A) of the step 14a of the blade portion 14. It is possible to prevent the guide section 16 from being pushed in the wrong direction without being deepened.
- the skin * is incised to perform the operation.
- the blade of the blade portion 14 is close to being parallel to the direction of the shaft 12
- the incision area can be made small, there is a disadvantage in that if the blade is inclined at a large angle, the skin incision must be enlarged to insert a tendon sheath incisor as shown in Fig. 9.
- the tendon sheath cutting knife according to the present invention is characterized in that these conditions are complemented to enable a suitable tendon sheath cutting.
- the blade provided at the tip of the blade part 14 is the rising part K from the guide part 16 to the blade part 14, the J part which is the middle part of the blade, and the upper part of the blade. It is divided into three parts, H.
- the K portion is a portion formed in an arc shape from the upper surface of the guide portion 16 to the blade portion 14, and the J portion and the H portion are portions formed linearly substantially parallel to the axial direction of the shaft 12. It is.
- the K portion and the J portion are formed so as to be smoothly continuous.
- the operation of each part of the blade of the blade part 14 is as follows.
- Part K is the main part that actually cuts the tendon sheath 20. Since the K portion is formed in an arc shape, the inclination angle of the blade when entering the tendon sheath 20 is smaller than that of the example in Fig. 5 and the like, and therefore, the action of incising the sheath 20 is extremely small. It is effective and can dramatically improve sharpness.
- the guide 16 is inserted between the tendon sheath 20 and the flexor tendon, and the incision is made while pushing the tendon sheath incision sideways and pushing sideways. As a result, the blade portion 14 moves so as to slide over the highest portion (M portion) of the tendon sheath 20 and cuts the tendon sheath 20.
- the part that contributes most to the incision of the tendon sheath 20 is the part K.
- the J section is the upper part of the K section.
- the tendon sheath 20 can be almost incised at the K section.
- the J part also joins the tendon sheath incision.
- the incision is made in section K and the thinned part is incised, so the sharpness remains the same.
- Section H is a part that does not normally contribute to the incision action, but in the case of the soft $ 20 bird, it may rise when incised. In that case, the H part will contribute to the incision.
- the effective part of the cutting operation moves from section J to section H. This can extend the life of the blade.
- the corner (point A) at the upper end of the H section is important as a reference position for visually measuring the depth of the blade section 14 or grasping the incision position by the blade section 14 during the cutting operation. You.
- the sharpness at the time of incision by 14 can be effectively improved, and the J and H parts are set up almost in parallel with the shaft 12 so that the cutting position by the blade part 14 and the visual reference
- the deviation from the position can be reduced, and the incision position can be reliably grasped, thereby enabling an accurate and safe operation. It is also preferable in that even if a blood vessel or a nerve hits the J portion or the H portion, it is unlikely to damage them.
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Surgical Instruments (AREA)
Description
Claims
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP96931225A EP0813844B1 (en) | 1995-09-19 | 1996-09-17 | Peritenon incision knife |
DE69626383T DE69626383T2 (de) | 1995-09-19 | 1996-09-17 | Peritendineum-messer |
US08/817,538 US5893861A (en) | 1995-09-19 | 1996-09-17 | Surgical knife for cutting out tendon sheath |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP7/239549 | 1995-09-19 | ||
JP23954995A JP3736877B2 (ja) | 1995-09-19 | 1995-09-19 | 腱鞘切開刀 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO1997010761A1 true WO1997010761A1 (fr) | 1997-03-27 |
Family
ID=17046467
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/JP1996/002668 WO1997010761A1 (fr) | 1995-09-19 | 1996-09-17 | Bistouri pour incision du peritendineum |
Country Status (5)
Country | Link |
---|---|
US (1) | US5893861A (ja) |
EP (1) | EP0813844B1 (ja) |
JP (1) | JP3736877B2 (ja) |
DE (1) | DE69626383T2 (ja) |
WO (1) | WO1997010761A1 (ja) |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US10383609B2 (en) | 2014-12-24 | 2019-08-20 | Public University Corporation Nara Medical University | Surgical instrument for making incisions |
Families Citing this family (18)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE19803175A1 (de) * | 1998-01-28 | 1999-07-29 | Technomed Ges Fuer Med Und Med | Messer |
EP1330986B1 (en) * | 2002-01-25 | 2009-12-09 | Terumo Kabushiki Kaisha | Vascular incision apparatus |
US8075575B2 (en) * | 2007-08-14 | 2011-12-13 | Toby Orthopaedics, Llc | Device and method for assisting in flexor tendon repair and rehabilitation |
US8579930B2 (en) | 2008-09-15 | 2013-11-12 | Del Palma Orthopedics, LLC | Surgical instrument and method of use for releasing soft tissue |
EP2326257A4 (en) | 2008-09-16 | 2012-12-12 | Toby Orthopaedics Llc | SHEAT EXPANSION INSTRUMENT FOR RECOVERING SUTURE POINT WIRES AND METHOD OF USE |
US8608763B1 (en) * | 2009-10-15 | 2013-12-17 | SonicSurg Innovations, LLC | Method for minimally invasive tendon sheath release |
US10219826B2 (en) | 2010-07-14 | 2019-03-05 | Seg-Way Orthopaedics, Inc. | Method and apparatus for endoscopic ligament release |
WO2013033634A1 (en) | 2011-09-01 | 2013-03-07 | Toby Orthopaedics, Llc | Tendon crimp for passage into a bone tunnel and method for use thereof |
US9364260B2 (en) | 2012-05-25 | 2016-06-14 | Depuy Mitek, Llc | Method for atraumatic hip access |
CA2914718C (en) * | 2013-08-07 | 2022-03-01 | Arthrex, Inc. | Meniscal probe cutter |
WO2016044072A1 (en) | 2014-09-18 | 2016-03-24 | Mayo Foundation For Medical Education And Research | Soft tissue cutting device and methods of use |
US10448965B2 (en) | 2014-11-12 | 2019-10-22 | Manuel F. DaSilva | Systems, methods, and devices for endoscopic nerve release |
CN109803595B (zh) * | 2016-10-13 | 2022-05-17 | 马尼株式会社 | 鼻用手术刀 |
US10864055B2 (en) | 2017-10-13 | 2020-12-15 | Sonex Health, Inc. | Tray for a soft tissue cutting device and methods of use |
US11937845B2 (en) | 2019-01-11 | 2024-03-26 | Mayo Foundation For Medical Education And Research | Micro-invasive surgical device and methods of use |
US12004767B2 (en) | 2021-01-08 | 2024-06-11 | Sonex Health, Inc. | Surgical cutting device for ultrasonic guided soft tissue surgery |
CN113116473A (zh) * | 2021-04-20 | 2021-07-16 | 李志刚 | 筋膜松解刀 |
USD989961S1 (en) | 2021-04-30 | 2023-06-20 | Sonex Health, Inc. | Soft tissue cutting device |
Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JPH03141939A (ja) * | 1989-10-30 | 1991-06-17 | Yoshiharu Yumoto | 腱鞘切開刀 |
Family Cites Families (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US1037693A (en) * | 1911-03-03 | 1912-09-03 | Edward L Watson | Veterinarian's castrating-knife. |
US3913585A (en) * | 1973-07-26 | 1975-10-21 | Technibiotics | Surgical cutting instrument |
DE3624243A1 (de) * | 1986-07-18 | 1988-01-28 | Wolfram Hein | Skalpellklinge |
US5282816A (en) * | 1991-09-20 | 1994-02-01 | Milres Corporation | Apparatus for subligamentous endoscopic transverse carpal ligament release surgery |
US5387222A (en) * | 1993-05-14 | 1995-02-07 | Strickland; James W. | Carpal tunnel tome and carpal tunnel release surgery |
US5397333A (en) * | 1993-09-24 | 1995-03-14 | Nusurg Medical, Inc. | Surgical hook knife |
US5681262A (en) * | 1994-10-05 | 1997-10-28 | Very Inventive Physicians Inc. | Endoscope and tool therefore |
-
1995
- 1995-09-19 JP JP23954995A patent/JP3736877B2/ja not_active Expired - Lifetime
-
1996
- 1996-09-17 WO PCT/JP1996/002668 patent/WO1997010761A1/ja active IP Right Grant
- 1996-09-17 DE DE69626383T patent/DE69626383T2/de not_active Expired - Lifetime
- 1996-09-17 US US08/817,538 patent/US5893861A/en not_active Expired - Lifetime
- 1996-09-17 EP EP96931225A patent/EP0813844B1/en not_active Expired - Lifetime
Patent Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JPH03141939A (ja) * | 1989-10-30 | 1991-06-17 | Yoshiharu Yumoto | 腱鞘切開刀 |
Non-Patent Citations (1)
Title |
---|
See also references of EP0813844A4 * |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US10383609B2 (en) | 2014-12-24 | 2019-08-20 | Public University Corporation Nara Medical University | Surgical instrument for making incisions |
Also Published As
Publication number | Publication date |
---|---|
JP3736877B2 (ja) | 2006-01-18 |
EP0813844B1 (en) | 2003-02-26 |
DE69626383T2 (de) | 2003-10-23 |
US5893861A (en) | 1999-04-13 |
DE69626383D1 (de) | 2003-04-03 |
EP0813844A4 (en) | 1999-12-08 |
EP0813844A1 (en) | 1997-12-29 |
JPH0975362A (ja) | 1997-03-25 |
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