Flexible telescopic flute needle for transmicrophthalmia subretinal fluid suctionTechnical Field
The invention relates to the technical field of medical instruments, in particular to a bendable telescopic flute needle for subretinal fluid suction of a fissured hole line.
Background
The retinal detachment is a common retinal disease in clinic, and on the basis of formation of retinal holes, liquefied vitreous bodies enter between retinal nerve epithelium and pigment epithelium through the holes to form retinal detachment. Before onset, retinal vitreous degeneration is common, such as peripheral retinal degeneration including lattice degeneration, snail-trail degeneration, etc., vitreous degeneration including vitreous liquefaction degeneration, posterior vitreous detachment, etc., abnormal adhesion enhancement between vitreous and retina, developmental vitreoretinal variation, etc. The mainstream opinion now holds that the main factors causing pore-derived retinal detachment are: "force" -vitreous traction on retina 3 "water" -fluid flows continuously through the retinal pores into the subretinal space. However, normally, there is a force between the retinal neuroepithelium and the pigment epithelium, and only 1.4% of retinal tears develop into retinal detachment even if retinal holes are present. When the adhesion between the neuroepithelium and the pigment epithelium is weakened and there is traction around the retinal tear, contact of the liquefied vitreous with the retinal tear may lead to the occurrence of rhegmatogenous retinal detachment. If an effective treatment mode is not adopted in time, serious vision loss and even eyeball atrophy can be caused. The operation principle is to close the fissure hole and relieve or relieve the traction of the pathological vitreous body on the retina. Common surgical methods comprise scleral buckling and vitrectomy, combined condensation or photocoagulation in the operation and combined intraocular long-acting gas or silicone oil filling, so that the success rate of postoperative retinal reattachment is greatly improved, however, in the actual operation process, for some special cases, such as retinal detachment patients caused by peripheral retinal holes, some matching instruments are still incomplete at present. The flute needle is one of important instruments in the vitrectomy, and can be used for gas-liquid exchange and absorbing subretinal fluid to assist in retinal replacement. When the traditional straight flute needle is used for sucking and removing subretinal fluid of a peripheral retinal fissure, the traditional straight flute needle is easy to touch the crystalline lens to cause iatrogenic cataract, and the traditional straight flute needle cannot be effectively attached to the choroid under the retinal fissure to cause incomplete sucking and removing of the subretinal fluid and even iatrogenic fissure. In addition, the length of the traditional cartesian needle is fixed, and the subretinal fluid cannot be effectively absorbed when the axis of the eye is too long, such as high myopia. The literature indicates that even if a very small amount of subretinal fluid remains, some patients cannot absorb the fluid after the operation, thereby affecting the vision prognosis. Therefore, there is an urgent need for improvement of the conventional cartesian needle.
Chinese patent documents: CN 201820751887.1. Application date 2018.05.09, with patent names: an ophthalmic telescopic flute needle. The telescopic flute needle for ophthalmology comprises a flute needle rod, a visual marker tube and a needle head, wherein the visual marker tube is positioned on the outer side wall of the flute needle rod, and a silicone tube is connected in the corresponding flute needle rod; the needle head is connected with the flute needle rod through a rotary telescopic device, extends into the cavity of the flute needle rod and is communicated with a silicone tube in the cavity of the flute needle rod; rotatory telescoping device includes connecting thread circle, rotatory rim plate, retainer plate and promotion spring, connecting thread circle and flute needle bar tip external screw thread looks adaptation connection, and the rotating wheel circle overlaps at the connecting thread circle other end, places between connecting thread circle and the rotatory rim plate in retainer plate and the promotion spring, and the retainer plate has been alternated in proper order to the syringe needle and promotes spring middle part hole to it is fixed through the stable cover of retainer plate.
Chinese patent documents: CN201721119762.9, application date 2017.08.31, patent names: an ophthalmologic operation protractile flute needle. The utility model discloses an ophthalmology operation protractile flute needle, including the needle body, the cavity, syringe needle seat, the spout, the slider, the screw rod, the screw hole, the mounting groove has been seted up to the lower extreme of syringe needle seat, install the syringe needle connecting seat in the mounting groove, the connecting plate is installed to the lower extreme of syringe needle connecting seat, the lower extreme center fixed mounting of connecting plate has the syringe needle, the screw rod passes through the bearing and is connected with the upper end rotation of cavity, the through-hole has been seted up to the left side wall of needle body, through-hole intercommunication cavity sets up, the inside fixed mounting of through-hole.
Chinese patent documents: CN201921412477.5, application date 2019.08.28, patent names: a ipsilateral curved flute needle for a retinal vitreous surgery. The same-side bent type flute needle for the retinal vitreous surgery comprises a liquid storage tube, wherein a piston is attached to the inner wall of the liquid storage tube, the left end of the piston is fixedly connected with a first L-shaped rod, one end, far away from the piston, of the first L-shaped rod is fixedly connected with a second L-shaped rod, one end, far away from the first L-shaped rod, of the second L-shaped rod is fixedly connected with a push block, the left end of the liquid storage tube is fixedly connected with an inner rod, and the surface of the inner rod is provided with a first sliding groove matched with the first L-shaped rod; according to the invention, the first L-shaped rod and the second L-shaped rod which are connected between the push block and the piston in a matching manner are adopted to achieve the effect that the piston can be pushed by pushing the push block, and the first sliding groove formed in the surface of the inner rod and the second sliding groove formed in the surface of the outer tube play a role of providing a sliding space for the first L-shaped rod and the second L-shaped rod.
The retractable flute needle for ophthalmology in the patent document CN201820751887.1 has a simple structure, can realize stepless retraction of a needle head through a screw, is not limited by an eye axis in an operation, and is convenient to use, but the front end of the retractable flute needle cannot be bent, and cannot play a role in thoroughly sucking accumulated liquid under a peripheral omentum; the stretchable flute needle in the patent document CN201721119762.9 for the ophthalmic operation is convenient to use, the using length of the needle head can be changed according to requirements, the length adjustment is slowly carried out, the retina of a patient cannot be injured, and the stretchable flute needle is suitable for popularization and use, but the front end of the stretchable flute needle is not provided with a silica gel sleeve, so that the effect of protecting the retina cannot be achieved, and the front needle cannot be bent, so that the effect of thoroughly sucking effusion under the peripheral part of the retina cannot be achieved; the ipsilateral curved cartesian needle used for the retinal vitreous surgery in patent document CN201921412477.5 has the advantage of precisely controlling the amount of liquid medicine injected into the eye, but the device aims to precisely control the injection amount without sucking the liquid under the retina, and the device cannot achieve the effect of controlling the length and the curvature of the needle head.
In summary, there is a need for a bendable telescopic flute needle for subretinal fluid aspiration through the hiatus in the hiatus retinal detachment reduction, which can adjust the length and the curvature, can be used for assisting the subretinal fluid aspiration through the peripheral hiatus in the porogenic retinal detachment reduction, is beneficial to more fully aspirating the subretinal fluid while avoiding iatrogenic injury, removes the fluid accumulated in the hiatus, provides a proper environment for the migration of photoreceptor cells, is easy to grow and recover the structure of the retinal nerve epithelium, further promotes the healing of the hiatus, can be used for aspirating residual perfluorocarbon liquid drops under the retina, is simple and convenient to operate, can improve the retinal repositioning condition of a patient, and can improve the vision prognosis of the patient.
Disclosure of Invention
The invention aims to overcome the defects of the prior art, provides the bendable telescopic flute needle capable of adjusting the length and the curvature, can be used for assisting the subretinal fluid suction through peripheral fissures in the porogenic retinal detachment reduction operation, is beneficial to more fully sucking the subretinal fluid while avoiding iatrogenic injury, and removing the fluid accumulated in the fissures, provides a proper environment for the migration of photoreceptor cells, is easy to grow and recover the neural epithelial structure of the retina, further promotes the healing of the fissures, can be used for sucking residual perfluorocarbon liquid drops under the retina, is simple and convenient to operate, can improve the retinal repositioning condition of a patient, and can improve the vision prognosis of the patient.
In order to achieve the purpose, the invention adopts the technical scheme that:
a flexible telescopic flute needle used for absorbing and removing the subretinal effusion through the fissure hole line comprises a flute needle body, a flute needle head, a length adjusting device and a flexible telescopic device; the flute needle head is arranged inside the right end of the flute needle body; the length adjusting device comprises a push-pull rod, a screw device, a closed piston, a connecting rod, a spring, a hollow piston and a silica gel needle head; the front section of the push-pull rod is arranged outside the left end of the whistle needle body, and a spiral device is connected below the front section; the tail section of the push-pull rod is arranged in the flute needle body and is connected with a liquid storage pipe arranged in the flute needle body through a closed piston; the whistle needle head is arranged on the inner side of the silica gel needle head, and a spring is arranged on the surface of the front section of the whistle needle head; the bending and stretching device is arranged on the lower side surface of the flute needle body, is communicated with the flute needle body and the liquid storage tube, and comprises a sliding block, a sliding chute, a shaft and a medical polypropylene elastic wire; the sliding chute is arranged on the lower side surface of the whistle needle body; the sliding block is arranged at the tail end of the sliding groove; the shaft is arranged inside the sliding chute; the medical polypropylene elastic thread main body penetrates through the winding shaft, and two ends of the medical polypropylene elastic thread main body are respectively fixedly connected with the sliding groove and the whistle needle head.
As a preferred technical scheme, a liquid storage pipe is further arranged inside the tube cavity of the whistle needle body, and a liquid suction port is formed in the upper side face of the tube cavity.
As a preferred technical scheme, the hollow piston is arranged at the tail end of the liquid storage pipe; the connecting rod is arranged in the liquid storage pipe, and two ends of the connecting rod are respectively connected with the closed piston and the hollow piston.
As an optimal technical scheme, the end section of the silica gel needle head is arranged inside the flute needle body and connected with the front end of the liquid storage tube, and the front section of the silica gel needle head is arranged outside the flute needle body.
As a preferred technical scheme, the silica gel syringe needle is made of medical silica gel and is of an asymmetric structure, the outer diameter of the silica gel syringe needle is 1.8mm, the inner diameter of the silica gel syringe needle is 1.4mm, the thicknesses of two sides are uneven, one side of the threading is thinner, and the other side of the threading is thicker.
As a preferred technical scheme, the length of the silica gel needle head is 50mm, wherein 25mm is arranged in the flute needle body, 25mm is arranged outside the flute needle body, the length of the telescopic part of the silica gel needle head is 20mm after the spring is folded, and the front end of the silica gel needle head can be bent by 0-45 degrees through folding the tube wall after the sliding block is pulsed.
As a preferable technical proposal, the medical polypropylene elastic thread has the length of about 100 mm.
The invention has the advantages that:
1. the invention achieves the effect that the piston can be pushed by pressing or retracting the push-pull rod through the push-pull rod and the piston and matching with the connecting rod, the spring and the like in the middle so as to control the extension of the silica gel needle head; the screw device is rotated in the pressing process, so that the silica gel needle head can be controlled to be extended to the desired length; when the nut is rotated in the forward direction, the screw rotates towards the side of the push-pull rod to tightly press the push-pull rod, so that the length of the silica gel needle head can be fixed, and when the nut is rotated in the reverse direction, the screw is far away from the push-pull rod, so that the push-pull rod can be adjusted again; the device has the advantage of prolonging the length of the flute needle head to adapt to different eye axes and fissure positions.
2. According to the medical needle, the medical polypropylene elastic wire is wound around the shaft by poking the sliding block, so that the elastic wire loosened in the silica gel needle head is pulled, and the silica gel needle head is bent towards one side of a thinner threading; the anti-slip coating on the sliding block can increase the friction force between the fingers and the sliding block, plays a role in preventing slipping in fine operation, and avoids the problem that the retina of a patient is punctured due to slipping.
3 can be used for assisting the subretinal fluid suction through peripheral fissures in the porogenic retinal detachment reduction operation, is beneficial to more fully sucking the subretinal fluid while avoiding iatrogenic injury, removes the fluid accumulated in the fissures, provides a proper environment for the migration of photoreceptor cells, ensures that the neural epithelial structure of the retina of the user is easier to grow and recover, further promotes the healing of the fissures, can be used for sucking and removing the residual perfluorocarbon liquid drops under the retina, is simple and convenient to operate, can improve the retinal reduction condition of a patient, and can improve the vision prognosis of the patient.
Drawings
FIG. 1 is a schematic plane view of a flexible telescopic flute needle for subretinal fluid aspiration through the hiatus.
FIG. 2 is a front view of a silicone tip of a bendable telescoping cartesian needle for transforaminal subretinal fluid aspiration of the present invention.
FIG. 3 is a top view of a silicone tip of a bendable telescoping whistles for aspiration of subretinal fluid through the foramen.
FIG. 4 is a front view of a controlled silicone needle bending device of a bendable telescoping flute needle for transforaminal subretinal fluid aspiration of the present invention.
FIG. 5 is a schematic view of a spiral device of the present invention for use in suction of subretinal fluid through the fissured holes.
Detailed Description
The invention is further described with reference to the following examples and with reference to the accompanying drawings.
The reference numerals and components referred to in the drawings are as follows:
1.flute needle body 11. liquid storage tube
12.Liquid suction port 2 flute needle
3.Length adjusting device 31, push-pull rod
32. Screw device 321, nut
322.Flat head screw 33, nut
33. Closedpiston 34 connecting rod
35.Spring 36. hollow piston
37. Silica gel needle 4. bending telescopic device
41.Slide block 42, chute
43. Medical polypropylene elastic thread aroundshaft 44
Example 1
Referring to fig. 1, fig. 1 is a schematic plan view of a bendable telescopic cartesian needle for subretinal fluid aspiration through a hiatus. A flexible telescopic flute needle used for absorbing and removing the subretinal effusion through the fissure hole line comprises a flute needle body 1, a flute needle head 2, a length adjusting device 3 and a flexible telescopic device 4; the flute needle body 1 is of a hollow tubular structure; the flute needle head 2 is arranged inside the right end of the flute needle body 1; the length adjusting device 3 comprises a push-pull rod 31, a screw device 32, a closed piston 33, a connecting rod 34, a spring 35, a hollow piston 36 and a silica gel needle 37; the tube cavity of the flute needle body 1 is also internally provided with a liquid storage tube 11, and the upper side surface of the tube cavity is provided with a liquid suction port 12; the front section of the push-pull rod 31 is arranged outside the left end of the whistle needle body, and a screw device 32 is connected below the front section; the tail section of the push-pull rod 31 is arranged in the flute needle body 1 and is connected with the liquid storage tube 11 arranged in the flute needle body 1 through a closed piston 33; the hollow piston 36 is arranged at the tail end of the liquid storage pipe 11; the connecting rod 34 is arranged inside the liquid storage pipe 11, and two ends of the connecting rod are respectively connected with the closed piston 33 and the hollow piston 36; the tail section of the silica gel needle 37 is arranged in the flute needle body 1 and connected with the front end of the liquid storage tube 11, and the front section of the silica gel needle 37 is arranged outside the flute needle body 1; the flute needle head 2 is arranged on the inner side of the silica gel needle head 37, and a spring 35 is arranged on the surface of the front section of the flute needle head 2; the silica gel needle 37 is designed to be of an asymmetric structure; the bending expansion device 4 is arranged on the lower side surface of the whistle needle body 1, is communicated with the whistle needle body 1 and the liquid storage pipe 11, and comprises a sliding block 41, a sliding groove 42, a winding shaft 43 and a medical polypropylene elastic line 44; the sliding chute 42 is arranged on the lower side surface of the whistle needle body 1; the sliding block 41 is arranged at the tail end of the sliding groove 42; the shaft 43 is arranged in the chute 43; the main body of the medical polypropylene elastic thread 44 passes through the winding shaft 43, and both ends of the medical polypropylene elastic thread are respectively fixedly connected with the chute 41 and the whistle needle 2.
It should be noted that: the total length of the flute needle is 150-160 mm; the length of the silica gel needle 37 is 50mm, wherein 25mm is in the flute needle body 1, 25mm is outside the flute needle body 1, after the spring 5 is folded, the length of the telescopic part of the silica gel needle 37 is 20mm, and after the pulsation slide block 41, the front end of the silica gel needle 37 can be bent for 0-45 degrees through folding the tube wall (refer to the attached figure 2); the outer diameter of the silica gel needle 37 is 1.8mm, the inner diameter is 1.4mm, the thicknesses of two sides are uneven, one threading side is thinner, and the opposite side is thicker, so that the silica gel needle can be bent towards the threading side; the medical polypropylene elastic thread 44 is about 100mm long, passes through the silica gel wall, achieves the purpose of bending by pulling a thin thread, and does not destroy the tightness of the tube cavity (refer to the attached figure 3); the silica gel needle 37 is made of medical silica gel (the main component is made of one or more of high-elasticity synthetic rubber, polyurethane and silicon rubber), has good elasticity and biocompatibility, is nontoxic, non-allergic and non-irritant to a human body, and reduces the rejection reaction of the body; the material has good and stable physicochemical properties, can keep the original elasticity and softness in the contact process with body fluid and tissues, is not degraded, and is a stable inert substance; the medical polypropylene elastic thread 44 can resist high temperature, can be sterilized, is convenient to process and form, and is easy to pass through and fix in the medical polypropylene elastic thread; the polypropylene is hard plastic, and the polyethylene and the rubber are added, so that the polypropylene can be modified into a softer elastomer with higher impact resistance, and the polypropylene can be used for repeated disinfection; in the device of the invention, the silica gel needle 37 adopts an asymmetric design, namely, one side containing the medical polypropylene elastic thread is a thin side, and the opposite side is a thick side, so that the design is beneficial to bending the silica gel needle 37 to the thin side; the nut 31 in the screw device 32 is connected with the housing of the flute needle body 1, and the screw cap 32 can be screwed or unscrewed by rotating the nut 32 so as to fix or move the push-pull rod 31 (refer to fig. 5); after the push-pull rod 31 is pressed to a certain degree, the extension length of the silica gel needle 37 at the moment can be fixed through rotating the screw device 32, and the slide block 41 on the side can be shifted at the moment, and an anti-skid coating is coated on the slide block, so that the bending degree of the needle during shifting is more controllable; when the liquid suction is suspended, the slide block 41 is loosened, the screw device 32 is rotated in the opposite direction after the bent needle head is recovered, the push-pull rod 31 is pulled, and the silica gel needle head 37 can be retracted, so as to avoid the situation that the bent needle head cannot pass through the conventional sclera puncture when the whistle needle is pulled out (specifically, the slide block 41 is slowly pulled downwards to the needle head side, the elastic wire 44 is slowly coiled on the shaft 43, the coiling length is about 15mm, the front part of the needle head is bent to the threading side along with the coiling length, so that the liquid under the retina can be more completely sucked, and the slide block 41 is slowly pulled in the opposite direction, so that the bent whistle needle head 2 (see figure 4) can be recovered).
The invention has the following effects:
1. the invention achieves the effect that the piston can be pushed by pressing or retracting the push-pull rod through the push-pull rod and the piston and matching with the connecting rod, the spring and the like in the middle so as to control the extension of the silica gel needle head; the screw device is rotated in the pressing process, so that the silica gel needle head can be controlled to be extended to the desired length; when the nut is rotated in the forward direction, the screw rotates towards the side of the push-pull rod to tightly press the push-pull rod, so that the length of the silica gel needle head can be fixed, and when the nut is rotated in the reverse direction, the screw is far away from the push-pull rod, so that the push-pull rod can be adjusted again; the device has the advantage of prolonging the length of the flute needle head to adapt to different eye axes and fissure positions.
2. According to the medical needle, the medical polypropylene elastic wire is wound around the shaft by poking the sliding block, so that the elastic wire loosened in the silica gel needle head is pulled, and the silica gel needle head is bent towards one side of a thinner threading; the anti-slip coating on the sliding block can increase the friction force between the fingers and the sliding block, plays a role in preventing slipping in fine operation, and avoids the problem that the retina of a patient is punctured due to slipping.
The foregoing is only a preferred embodiment of the present invention, and it should be noted that, for those skilled in the art, various modifications and additions can be made without departing from the principle of the present invention, and these should also be considered as the protection scope of the present invention.