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CN110537954A - Drill bits for minimally invasive total hip replacement surgery - Google Patents

Drill bits for minimally invasive total hip replacement surgery
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CN110537954A
CN110537954ACN201910794398.3ACN201910794398ACN110537954ACN 110537954 ACN110537954 ACN 110537954ACN 201910794398 ACN201910794398 ACN 201910794398ACN 110537954 ACN110537954 ACN 110537954A
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diameter
flexible shaft
cutting head
minimally invasive
axial length
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谢军
章洪喜
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Abstract

The invention relates to a drill bit for a total hip joint replacement minimally invasive surgery, which comprises a flexible shaft consisting of a spring with certain rigidity and certain flexibility, wherein two ends of the flexible shaft are respectively welded with a handle part and a cutting head; the cutting head is made of 316L stainless steel, so that the serious consequence that the drill bit is broken in the acetabular bone when the drill is drilled in a bending state and cannot be taken out is avoided, and after the drill is finished, a screw with a proper length is screwed in along the inner cavity of the isolation sleeve through the direction-changeable screwdriver so as to reinforce and fixedly connect the acetabular metal component, so that the cutting head is safe, reliable and convenient to operate.

Description

Translated fromChinese
全髋关节置换微创手术用钻头Drill bits for minimally invasive total hip replacement surgery

技术领域technical field

本发明涉及一种全髋关节置换微创手术用钻头。The invention relates to a drill bit for minimally invasive surgery of total hip joint replacement.

背景技术Background technique

传统全髋关节置换手术需切断外旋肌,破坏关节囊完整性,导致髋关节周围肌肉功能受到影响,手术过程中还需要进行外科脱位,需要多人配合协同完成;SUPERPATH微创化全髋关节置换手术因其切口长度小,仅为6cm~8cm,手术过程中不需切断外旋肌,经犁状肌和臀小肌的间隙进入,几乎保留了髋关节周围所有的肌肉功能,和完整的关节囊;手术操作过程中不需要外科脱位,术中不造成肢体极度的旋转与扭曲,手术只需由主刀和助力2人协助即可完成,因而成为关节外科医生一直探索的目标;该技术由美国亚利桑那州凤凰城圣路加医学中心James Chow博士首创,(St. Luke's Medical Center,Phoenix,Arizona,USA),SuperPATH入路(Supercapsular Percutaneously Assisted Total Hip)是经标准后侧入路改良而来,SuperPATHTM入路保留了标准后侧入路的所有优点,还可以进一步延伸,很容易的转换成标准后侧入路;微创化全髋关节置换手术的手术切口小而深,并具有一定倾斜角度,钻头需沿曲折路线路径伸入至钻孔位置,同时还要防止损伤切口周围的很多神经肌肉等重要结构,因而很难从微小切口中植入髋臼金属部件的固定螺钉,操作不方便,普通硬质工具钢钻头在弯曲状态钻孔时钻头易折断在髋臼骨质里面,造成无法取出的严重后果,需要提供一种安全可靠、操作方便的微创化全髋关节置换手术专用髋臼钻头。Traditional total hip replacement surgery needs to cut off the external rotators and destroy the integrity of the joint capsule, which will affect the function of the muscles around the hip joint. Surgical dislocation is also required during the operation, which requires the cooperation of multiple people; SUPERPATH minimally invasive total hip joint Due to the small incision length of the replacement surgery, which is only 6cm to 8cm, the external rotator muscle does not need to be cut during the operation. Joint capsule; no surgical dislocation is required during the operation, and the operation does not cause extreme rotation and distortion of the limbs. The operation can be completed only with the assistance of the surgeon and the assistant. Therefore, it has become the goal that joint surgeons have been exploring; this technology is developed by Initiated by Dr. James Chow of St. Luke's Medical Center in Phoenix, Arizona, USA (St. Luke's Medical Center, Phoenix, Arizona, USA), the SuperPATH approach (Supercapsular Percutaneously Assisted Total Hip) is improved from the standard posterior approach. The SuperPATHTM approach retains all the advantages of the standard posterior approach, and can be further extended, and can be easily converted into a standard posterior approach; minimally invasive total hip replacement surgery has a small and deep surgical incision with a certain oblique angle , the drill bit needs to be inserted into the drilling position along a tortuous path, and at the same time, it is necessary to prevent damage to many neuromuscular and other important structures around the incision. Therefore, it is difficult to implant the fixation screw of the acetabular metal part from the tiny incision, and the operation is inconvenient. Ordinary hard tool steel drill bits are easily broken in the acetabular bone when drilling in a bent state, resulting in serious consequences that cannot be removed. It is necessary to provide a safe, reliable, and easy-to-operate acetabular joint for minimally invasive total hip replacement surgery. drill.

发明内容Contents of the invention

本发明所要解决的技术问题是,提供一种能够适应微创化全髋关节置换手术在小而深的手术切口内植入髋臼金属部件的固定螺钉,不会损伤切口周围的很多神经肌肉等重要结构,安全可靠,操作方便的全髋关节置换微创手术用钻头。The technical problem to be solved by the present invention is to provide a fixation screw that can adapt to minimally invasive total hip replacement surgery and implant acetabular metal parts in a small and deep surgical incision without damaging many nerves and muscles around the incision. Important structure, safe and reliable, easy to operate drill bit for minimally invasive surgery of total hip replacement.

本发明的全髋关节置换微创手术用钻头,其特征在于:包括柄部、软轴、切削头,软轴由一段弹簧构成,软轴两端分别通过焊接固定连接在柄部、切削头上;切削头由位于上段的固定连接段和位于下段的切削部构成,固定连接段直径大于切削部,使得切削头外圆周面上构成限位台阶,切削部外部套装有能够沿切削部上下滑动的限位导向套,限位导向套外径大于切削头的固定连接段外径,内径小于切削头的固定连接段外径,限位导向套轴向长度小于切削部的轴向长度,限位导向套外圆周面上固定连接有倾斜设置的操作手柄;软轴外部套装有能够沿软轴上下滑动的隔离套,隔离套内径、软轴直径、固定连接段直径、切削部直径之间关系为隔离套内径>固定连接段直径>软轴直径>切削部直径;隔离套轴向长度小于软轴轴向长度;The drill bit for total hip joint replacement minimally invasive surgery of the present invention is characterized in that it includes a handle, a flexible shaft, and a cutting head, the flexible shaft is composed of a section of spring, and the two ends of the flexible shaft are respectively fixedly connected to the handle and the cutting head by welding The cutting head is composed of a fixed connection section located in the upper section and a cutting part located in the lower section. The diameter of the fixed connection section is larger than that of the cutting part, so that a limit step is formed on the outer peripheral surface of the cutting head. Limit guide sleeve, the outer diameter of the limit guide sleeve is larger than the outer diameter of the fixed connection section of the cutting head, the inner diameter is smaller than the outer diameter of the fixed connection section of the cutting head, the axial length of the limit guide sleeve is less than the axial length of the cutting part, the limit guide The outer circumference of the sleeve is fixedly connected with an inclined operating handle; the outer sleeve of the flexible shaft is equipped with a spacer sleeve that can slide up and down along the flexible shaft. The relationship between the inner diameter of the spacer sleeve, the diameter of the flexible shaft, the diameter of the fixed connection section, and the diameter of the cutting part is isolation The inner diameter of the sleeve>the diameter of the fixed connection section>the diameter of the flexible shaft>the diameter of the cutting part; the axial length of the spacer sleeve is less than the axial length of the flexible shaft;

所述柄部上段直径小于下段直径,构成装夹头;柄部下端面、切削部上端面分别设置有沉孔,沉孔内径与软轴直径互相适应,软轴上下两端分别配合安装在沉孔内,并通过焊接固定连接;The diameter of the upper section of the shank is smaller than the diameter of the lower section, forming a chucking head; the lower end surface of the shank and the upper end surface of the cutting part are respectively provided with counterbore holes, the inner diameter of the counterbore hole and the diameter of the flexible shaft are compatible with each other, and the upper and lower ends of the flexible shaft are respectively fitted in the counterbore. inside, and fixed connection by welding;

所述隔离套轴向长度是软轴轴向长度的1/3~1/2;The axial length of the spacer sleeve is 1/3 to 1/2 of the axial length of the flexible shaft;

所述操作手柄与限位导向套轴心之间夹角为30°;The angle between the operating handle and the axis of the limit guide sleeve is 30°;

所述隔离套、切削头材料为医用316L不锈钢;The material of the isolation sleeve and the cutting head is medical 316L stainless steel;

所述限位导向套轴向长度也为切削部轴向长度的1/3~1/2;The axial length of the limit guide sleeve is also 1/3 to 1/2 of the axial length of the cutting part;

所述操作手柄上段外部套装有防滑套。The upper portion of the operating handle is covered with a non-slip sleeve.

本发明的全髋关节置换微创手术用钻头,由具有一定刚性同时具有一定柔性的弹簧构成软轴,软轴两端分别焊接连接柄部、切削头,在手术切口以远5CM左右另外建立一个髋臼螺钉固定孔,采用尖头穿刺器穿刺完成;在穿刺孔中置入不锈钢隔离套,软轴下端的切削头沿隔离套内腔置入,通过操作手柄在手术切口中放入限位导向套,经软轴驱动切削头沿限位导向套向下限位钻孔,限位导向套可避免钻孔过深进入盆腔;柔性长钻头头部使用316L不锈钢钻头代替硬质工具钢钻头,可以防止在弯曲状态钻孔时钻头折断在髋臼骨质里面,造成无法取出的严重后果,软轴与切削头沿隔离套内腔转入工作,在高速旋转时不会损伤患者肌肉神经等重要结构;钻孔完成后,通过可变向改锥沿隔离套内腔拧入合适长度的螺钉,以便加固定连接髋臼金属部件;能够适应微创化全髋关节置换手术在小而深的手术切口内植入髋臼金属部件的固定螺钉,不会损伤切口周围的很多神经肌肉等重要结构,安全可靠,操作方便。The drill bit for minimally invasive surgery of total hip joint replacement of the present invention is composed of a flexible shaft with a certain rigidity and flexibility at the same time. The two ends of the flexible shaft are respectively welded to connect the handle and the cutting head. The acetabular screw fixation hole is completed by puncturing with a pointed trocar; a stainless steel isolation sleeve is placed in the puncture hole, the cutting head at the lower end of the flexible shaft is placed along the inner cavity of the isolation sleeve, and a limit guide is placed in the surgical incision through the operating handle The cutting head is driven by the flexible shaft to limit drilling downward along the limit guide sleeve. The limit guide sleeve can avoid drilling too deep into the pelvic cavity; the flexible long drill head uses a 316L stainless steel drill bit instead of a hard tool steel drill bit, which can prevent When drilling in a bent state, the drill bit breaks in the bone of the acetabular bone, resulting in serious consequences that cannot be removed. The flexible shaft and cutting head are transferred to work along the inner cavity of the isolation sleeve, and will not damage important structures such as the patient's muscles and nerves during high-speed rotation; After the drilling is completed, a screw of appropriate length is screwed in along the inner cavity of the spacer sleeve with a reversible screwdriver, so as to fix and connect the acetabular metal parts; it can adapt to minimally invasive total hip replacement surgery and implant in small and deep surgical incisions The fixing screws inserted into the metal parts of the acetabulum will not damage many neuromuscular and other important structures around the incision, which is safe, reliable and easy to operate.

附图说明Description of drawings

图1是本发明实施例全髋关节置换微创手术用钻头的柄部、软轴、切削头平面结构示意图;Fig. 1 is a schematic diagram of the planar structure of the handle, flexible shaft and cutting head of the drill bit for total hip replacement minimally invasive surgery according to the embodiment of the present invention;

图2是本发明实施例全髋关节置换微创手术用钻头整体结构平面示意图;Fig. 2 is a schematic plan view of the overall structure of a drill bit for minimally invasive total hip replacement surgery according to an embodiment of the present invention;

图3是图2的剖面结构示意图。FIG. 3 is a schematic cross-sectional structure diagram of FIG. 2 .

具体实施方式Detailed ways

如图所示,一种全髋关节置换微创手术用钻头,特制一既具有一定柔性,又具有一定刚性的钻头,以解决如何从微小切口中沿曲折路径伸入至准确位置进行钻孔,植入髋臼金属部件固定螺钉的问题;具体结构包括由柄部1、软轴2、切削头3构成的钻头主体,其中软轴2是由一段同时具有一定柔性和刚性的弹簧构成,软轴2的两端分别通过焊接固定连接在柄部1、切削头3上,在手术过程中,软轴可以带动切削头沿曲折路径伸入至准确位置,并驱动切削头高速旋转进行钻孔。As shown in the figure, a drill bit for minimally invasive total hip replacement surgery is specially made with a certain degree of flexibility and rigidity to solve how to drill from a small incision along a tortuous path to an accurate position. The problem of implanting acetabular metal parts to fix screws; the specific structure includes a drill body composed of a handle 1, a flexible shaft 2, and a cutting head 3, wherein the flexible shaft 2 is composed of a spring with certain flexibility and rigidity at the same time, and the flexible shaft The two ends of 2 are respectively fixedly connected to the handle 1 and the cutting head 3 by welding. During the operation, the flexible shaft can drive the cutting head to extend to the exact position along the zigzag path, and drive the cutting head to rotate at high speed for drilling.

切削头3的具体结构是由位于上段的固定连接段31和位于下段的切削部32构成,固定连接段31的直径大于切削部32的直径,使得切削头3的外圆周面上构成限位台阶,在切削部32的外部套装一能够沿切削部上下滑动的限位导向套6,限位导向套6的外径大于切削头3的固定连接段31外径,内径小于切削头3的固定连接段31外径,限位导向套6的轴向长度小于切削部32的轴向长度,钻孔时,限位导向套为切削部提供钻孔导向和钻孔深度的限位,防止钻孔过深进入盆腔;为便于定位操作,在限位导向套6的外圆周面上固定连接一倾斜设置的操作手柄5,通过操作手柄5将限位导向套6放置于手术切口内底部的髋臼骨上方,操作方便;The specific structure of the cutting head 3 is composed of a fixed connection section 31 located at the upper section and a cutting portion 32 located at the lower section. The diameter of the fixed connection section 31 is larger than the diameter of the cutting section 32, so that the outer circumferential surface of the cutting head 3 forms a limit step , a limit guide sleeve 6 that can slide up and down along the cutting portion is set outside the cutting portion 32, the outer diameter of the limit guide sleeve 6 is greater than the outer diameter of the fixed connection section 31 of the cutting head 3, and the inner diameter is smaller than the fixed connection of the cutting head 3 Section 31 outer diameter, the axial length of the limit guide sleeve 6 is less than the axial length of the cutting portion 32, when drilling, the limit guide sleeve provides the cutting portion with drilling guide and the limit of the drilling depth, preventing excessive drilling. Deep into the pelvic cavity; for the convenience of positioning operation, an oblique operating handle 5 is fixedly connected to the outer circumferential surface of the limit guide sleeve 6, and the limit guide sleeve 6 is placed on the acetabular bone at the bottom of the surgical incision through the operation handle 5. above, easy to operate;

在软轴2的外部套装一隔离套4,将切削部32的直径、固定连接段31的直径、软轴2的直径、隔离套4的内径分别定义为D1、D2、D3、D4,隔离套4的内径、软轴2的直径、固定连接段31的直径、切削部32的直径之间关系为D4>D2>D3>D1,手术过程中,在手术切口以远5CM左右另外建立一个髋臼螺钉辅助固定孔,髋臼螺钉辅助固定孔可以采用尖头穿刺器穿刺完成,然后在髋臼螺钉辅助固定孔内穿入隔离套4,钻头主体的切削头穿过隔离套4内腔进入手术切口内部,然后由沿限位导向套6限位导向钻孔;钻头主体驱动切削头在隔离套内旋转切削钻孔,在高速旋转时不会损伤患者肌肉神经等重要结构。A spacer sleeve 4 is placed outside the flexible shaft 2, and the diameter of the cutting part 32, the diameter of the fixed connection section 31, the diameter of the flexible shaft 2, and the inner diameter of the spacer sleeve 4 are respectively defined as D1, D2, D3, and D4. The relationship between the inner diameter of 4, the diameter of the flexible shaft 2, the diameter of the fixed connection section 31, and the diameter of the cutting part 32 is D4>D2>D3>D1. During the operation, another acetabulum is established about 5 cm away from the surgical incision. Screw auxiliary fixation hole, acetabular screw auxiliary fixation hole can be punctured with a pointed puncturer, and then the isolation sleeve 4 is penetrated into the acetabular screw auxiliary fixation hole, and the cutting head of the drill body passes through the inner cavity of the isolation sleeve 4 and enters the surgical incision Inside, the drill hole is guided along the limit guide sleeve 6; the main body of the drill bit drives the cutting head to rotate and cut the drill hole in the isolation sleeve, which will not damage important structures such as the patient's muscles and nerves during high-speed rotation.

进一步地,柄部1的上段11的直径小于下段12的直径,构成装夹头结构,便于钻头主体与设备连接;在柄部1的下端面、切削部3的上端面分别设置一凹陷沉孔,沉孔的内径与软轴2的直径互相适应,软轴2的上下两端分别配合安装在沉孔内,并通过焊接固定连接,安装连接稳定可靠;Further, the diameter of the upper section 11 of the shank 1 is smaller than the diameter of the lower section 12, which constitutes a chuck structure, which facilitates the connection between the drill body and the equipment; a sunken counterbore is respectively set on the lower end surface of the shank 1 and the upper end surface of the cutting part 3 , the inner diameter of the counterbore and the diameter of the flexible shaft 2 are adapted to each other, and the upper and lower ends of the flexible shaft 2 are installed in the counterbore respectively, and are fixedly connected by welding, and the installation and connection are stable and reliable;

进一步地,将隔离套4的轴向长度设置为软轴2的轴向长度的1/3~1/2,本例中隔离套4的轴向长度设置为软轴2的轴向长度的1/2,隔离套4轴向长度为37.5mm,软轴2的轴向长度为75mm;限位导向套6轴向长度也为切削部32轴向长度的1/3~1/2,本例中限位导向套6的轴向长度设置为切削部32的轴向长度的1/2,限位导向套6轴向长度为11.5mm,切削部32的轴向长度为23mm;并将操作手柄与限位导向套轴心之间夹角设置为30°,操作方便,导向限位稳定,并且占用空间小,适应于小而深的手术切口空间要求;Further, the axial length of the spacer 4 is set to 1/3 to 1/2 of the axial length of the flexible shaft 2, and the axial length of the spacer 4 is set to 1/2 of the axial length of the flexible shaft 2 in this example. /2, the axial length of spacer sleeve 4 is 37.5mm, the axial length of flexible shaft 2 is 75mm; the axial length of limit guide sleeve 6 is also 1/3~1/2 of the axial length of cutting part 32, in this example The axial length of the middle limit guide sleeve 6 is set to 1/2 of the axial length of the cutting portion 32, the axial length of the limit guide sleeve 6 is 11.5 mm, and the axial length of the cutting portion 32 is 23 mm; and the operating handle The angle between the axis of the limit guide sleeve is set to 30°, which is convenient to operate, stable to guide and limit, and takes up little space, which is suitable for small and deep surgical incision space requirements;

再进一步地,隔离套、切削头的材料选择医用316L不锈钢,代替传统硬质工具钢钻头,可以防止在弯曲状态钻孔时钻头折断在髋臼骨质里面,避免造成无法取出的严重后果;Further, the material of the isolation sleeve and the cutting head is medical 316L stainless steel, which replaces the traditional hard tool steel drill bit, which can prevent the drill bit from breaking inside the acetabular bone when drilling in a bent state, and avoid serious consequences that cannot be removed;

最后,在操作手柄5的上段外部套装有防滑套51,防止打滑,定位精度高,安全可靠。Finally, an anti-slip sleeve 51 is sheathed outside the upper part of the operating handle 5 to prevent slipping, and the positioning accuracy is high, safe and reliable.

Claims (7)

Translated fromChinese
1.一种全髋关节置换微创手术用钻头,其特征在于:包括柄部、软轴、切削头,软轴由一段弹簧构成,软轴两端分别通过焊接固定连接在柄部、切削头上;切削头由位于上段的固定连接段和位于下段的切削部构成,固定连接段直径大于切削部,使得切削头外圆周面上构成限位台阶,切削部外部套装有能够沿切削部上下滑动的限位导向套,限位导向套外径大于切削头的固定连接段外径,内径小于切削头的固定连接段外径,限位导向套轴向长度小于切削部的轴向长度,限位导向套外圆周面上固定连接有倾斜设置的操作手柄;软轴外部套装有能够沿软轴上下滑动的隔离套,隔离套内径、软轴直径、固定连接段直径、切削部直径之间关系为隔离套内径>固定连接段直径>软轴直径>切削部直径;隔离套轴向长度小于软轴轴向长度。1. A drill bit for total hip replacement minimally invasive surgery, characterized in that: it comprises a shank, a flexible shaft, and a cutting head, the flexible shaft is made of a section of spring, and the two ends of the flexible shaft are respectively fixedly connected to the shank, the cutting head by welding Above; the cutting head is composed of a fixed connection section located in the upper section and a cutting part located in the lower section. The diameter of the fixed connection section is larger than that of the cutting part, so that a limit step is formed on the outer peripheral surface of the cutting head. The limit guide sleeve, the outer diameter of the limit guide sleeve is larger than the outer diameter of the fixed connection section of the cutting head, the inner diameter is smaller than the outer diameter of the fixed connection section of the cutting head, the axial length of the limit guide sleeve is less than the axial length of the cutting part, the limit The outer circumferential surface of the guide sleeve is fixedly connected with an inclined operating handle; the outer sleeve of the flexible shaft is equipped with a spacer sleeve that can slide up and down along the flexible shaft. The relationship between the inner diameter of the spacer sleeve, the diameter of the flexible shaft, the diameter of the fixed connection section, and the diameter of the cutting part is: The inner diameter of the spacer sleeve>the diameter of the fixed connection section>the diameter of the flexible shaft>the diameter of the cutting part; the axial length of the spacer sleeve is less than the axial length of the flexible shaft.2.根据权利要求1所述全髋关节置换微创手术用钻头,其特征在于:所述柄部上段直径小于下段直径,构成装夹头;柄部下端面、切削部上端面分别设置有沉孔,沉孔内径与软轴直径互相适应,软轴上下两端分别配合安装在沉孔内,并通过焊接固定连接。2. The drill bit for minimally invasive surgery of total hip joint replacement according to claim 1, characterized in that: the diameter of the upper section of the shank is smaller than the diameter of the lower section to form a chuck; the lower end surface of the shank and the upper end surface of the cutting part are respectively provided with counterbores , The inner diameter of the counterbore and the diameter of the flexible shaft are compatible with each other, and the upper and lower ends of the flexible shaft are respectively installed in the counterbore and fixedly connected by welding.3.根据权利要求1所述全髋关节置换微创手术用钻头,其特征在于:所述隔离套轴向长度是软轴轴向长度的1/3~1/2。3 . The drill bit for minimally invasive surgery of total hip joint replacement according to claim 1 , wherein the axial length of the spacer sleeve is 1/3 to 1/2 of the axial length of the flexible shaft.4.根据权利要求1所述全髋关节置换微创手术用钻头,其特征在于:所述操作手柄与限位导向套轴心之间夹角为30°。4 . The drill bit for minimally invasive surgery of total hip joint replacement according to claim 1 , wherein the angle between the operating handle and the axis of the limiting guide sleeve is 30°.5.根据权利要求1所述全髋关节置换微创手术用钻头,其特征在于:所述隔离套、切削头材料为医用316L不锈钢。5. The drill bit for minimally invasive surgery of total hip joint replacement according to claim 1, characterized in that: the material of the spacer sleeve and the cutting head is medical 316L stainless steel.6.根据权利要求1所述全髋关节置换微创手术用钻头,其特征在于:所述限位导向套轴向长度也为切削部轴向长度的1/3~1/2。6 . The drill bit for minimally invasive surgery of total hip joint replacement according to claim 1 , wherein the axial length of the position-limiting guide sleeve is also 1/3 to 1/2 of the axial length of the cutting part.7.根据权利要求1所述全髋关节置换微创手术用钻头,其特征在于:所述操作手柄上段外部套装有防滑套。7. The drill bit for minimally invasive surgery of total hip joint replacement according to claim 1, characterized in that: the upper part of the operating handle is covered with a non-slip sleeve.
CN201910794398.3A2019-08-272019-08-27 Drill bits for minimally invasive total hip replacement surgeryPendingCN110537954A (en)

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CN112998804B (en)*2021-03-182022-02-01中国人民解放军东部战区总医院Bone tunnel preparation device for knee joint ligament reconstruction

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Application publication date:20191206


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