CN-116421274-B - Ultrasonic surgical instrument for laminectomy

CN116421274BCN 116421274 BCN116421274 BCN 116421274BCN-116421274-B

Abstract

The invention discloses an ultrasonic surgical instrument for laminectomy, which relates to the technical field of medical instruments and comprises a handle, an ultrasonic shell, an ultrasonic bone knife assembly and a follow-up sleeve, wherein the handle is connected to the bottom of the ultrasonic shell, the follow-up sleeve is connected to the front end of the ultrasonic shell, the follow-up sleeve is used for being abutted against a vertebral plate to synchronously move with the vertebral plate, the ultrasonic bone knife assembly comprises an ultrasonic knife handle and a bone knife connected to one end of the ultrasonic knife handle, the ultrasonic knife handle is arranged in the ultrasonic shell, the bone knife is arranged in the follow-up sleeve, a driving mechanism for driving the ultrasonic bone knife assembly to reciprocate linearly is arranged in the ultrasonic shell, and when the follow-up sleeve is abutted against the vertebral plate, the ultrasonic bone knife assembly is driven to extend out of the follow-up sleeve through the driving mechanism to cut the vertebral plate. The invention can realize respiratory follow-up when the vertebral body is fluctuated due to the respiration of a patient, so as to accurately complete the cutting of the vertebral plate and ensure that spinal cord/nerve under the vertebral plate is not damaged.

Inventors

HU LEI
JI XUQUAN
ZHANG TIANYANG
XUE YUMEI

Assignees

北京航空航天大学

Dates

Publication Date: 20260505
Application Date: 20230516

Claims (7)

1. The ultrasonic surgical instrument for laminectomy is characterized by comprising a handle, an ultrasonic shell, an ultrasonic bone knife assembly and a follow-up sleeve, wherein the handle is connected to the bottom of the ultrasonic shell, the follow-up sleeve is connected to the front end of the ultrasonic shell and is used for being abutted to a vertebral lamina to move synchronously with the vertebral lamina, the ultrasonic bone knife assembly comprises an ultrasonic knife handle and a bone knife connected to one end of the ultrasonic knife handle, the ultrasonic knife handle is installed in the ultrasonic shell, the bone knife is arranged in the follow-up sleeve, a driving mechanism for driving the ultrasonic bone knife assembly to reciprocate linearly is arranged in the ultrasonic shell, and when the follow-up sleeve is abutted to the vertebral lamina, the ultrasonic bone knife assembly is driven to extend out of the follow-up sleeve through the driving mechanism to cut the vertebral lamina; The ultrasonic bone knife comprises an ultrasonic shell, an ultrasonic knife handle, a driving mechanism, a locking mechanism, a driving mechanism and an ultrasonic bone knife assembly, wherein the ultrasonic shell is internally provided with the locking mechanism, the ultrasonic knife handle is arranged on the locking mechanism, the locking mechanism comprises a locking fixing piece, a locking movable piece and a locking adjusting mechanism, the locking movable piece is connected to the locking fixing piece in a sliding mode, a first clamping piece is arranged on the locking movable piece, a second clamping piece corresponding to the first clamping piece is arranged on the locking fixing piece, the locking adjusting mechanism is connected with the locking movable piece and the locking fixing piece and is used for adjusting the distance between the locking movable piece and the locking fixing piece so that the first clamping piece and the second clamping piece are close to each other to clamp the ultrasonic knife handle, or the first clamping piece is far away from the second clamping piece to loosen the ultrasonic knife handle, and the locking fixing piece is connected with the driving mechanism and drives the locking mechanism to reciprocate linearly move to drive the ultrasonic bone knife assembly to reciprocate linearly; the driving mechanism comprises a base, a driving motor, a sliding table, a screw and screw nuts, wherein the base is fixedly connected in the ultrasonic shell, the driving motor is fixedly connected on the base, an output shaft of the driving motor is connected with the screw and used for driving the screw to rotate, the screw nuts are in threaded connection with the screw, a sliding rail is arranged on the base, a sliding block is connected onto the sliding rail in a sliding manner, the sliding table is fixedly connected onto the sliding block and is fixedly connected with the screw nuts, and a locking fixing piece is connected onto the sliding table in a sliding manner; The automatic bone knife cutting device is characterized in that a self-resetting advancing button, a self-resetting backing button and a self-resetting automatic identification button are arranged on the handle, the self-resetting advancing button, the self-resetting backing button and the self-resetting automatic identification button are respectively connected with the controller, forward rotation and reverse rotation of the driving motor are controlled through the self-resetting advancing button and the self-resetting backing button respectively to control the advancing and backing of the bone knife, and the self-resetting automatic identification button is used for controlling the bone knife to automatically cut vertebral plates.
2. The ultrasonic surgical laminectomy instrument of claim 1 wherein the locking adjustment mechanism comprises a locking crank, a locking connecting rod and a locking wrench, wherein a shaft on one side of the locking crank is rotatably connected to the locking fixture and is fixedly connected with the locking wrench, a shaft on the other side of the locking crank is rotatably connected to one end of the locking connecting rod, the other end of the locking connecting rod is rotatably connected to the locking moveable member, the locking crank is driven to rotate by the locking wrench, and the locking moveable member is driven to slide close to or far away from the locking fixture by the locking connecting rod.
3. The ultrasonic surgical laminectomy instrument of claim 1 wherein the base has two ends each provided with a limit switch, each limit switch being adapted to cooperate with two ends of the locking fixture to limit the travel of the drive motor.
4. The laminectomy ultrasonic surgical instrument of claim 1 wherein the drive motor is a screw motor and the depth of cut of the current tissue is calculated by an encoder carried by the drive motor.
5. The laminectomy ultrasonic surgical instrument of claim 1 wherein the ultrasonic housing has a display mounted thereon for displaying parameters associated with the laminectomy.
6. The ultrasonic surgical instrument for laminectomy according to claim 1, wherein the ultrasonic housing comprises a top ultrasonic housing and a bottom ultrasonic housing, wherein the top ultrasonic housing and the bottom ultrasonic housing are each provided with a housing attracting magnet, the housing attracting magnets are connected together through a magnetic attraction effect of the housing attracting magnets, a sleeve attracting magnet is fixedly arranged at the front end of the bottom ultrasonic housing, and a ferromagnetic piece corresponding to the sleeve attracting magnet is fixedly arranged on the follow-up sleeve, and the sleeve attracting magnet and the ferromagnetic piece are connected together through a magnetic attraction effect between the sleeve attracting magnet and the ferromagnetic piece.
7. The ultrasonic surgical instrument for laminectomy according to claim 1, wherein the handle has a slot at a top end thereof, an insert is provided at a bottom end of the ultrasonic housing, the insert is coupled to the slot by rotating a cam mechanism, and the insert is tightly coupled to the slot by rotating the cam mechanism to push the cam mechanism against a bottom surface of the ultrasonic housing after the insert is inserted into the slot.

Description

Ultrasonic surgical instrument for laminectomy Technical Field The invention relates to the technical field of medical instruments, in particular to a laminectomy ultrasonic surgical instrument. Background Spinal laminectomy is a key step in spinal surgery, and is a treatment method for removing the lamina and relieving spinal cord and nerve compression caused by spinal stenosis by surgery. The method mainly has three clinical difficulties in the implementation process, namely (1) from the operation action, the selection of the decompression position and whether the incision is penetrated depend on the experience, the manipulation and the current state of doctors, and the randomness is large, (2) from the operation space, the wound is narrow, the operation area is limited, the access and the operation of operation tools are difficult, and (3) from the operation view, the doctor view is limited due to the narrow wound and the shielding of soft tissues. Therefore, how to effectively reduce the complications of the decompression operation, improve the safety and the curative effect of the operation, and is a great challenge for spinal surgery (especially for minimally invasive spinal surgery). The intelligent equipment such as navigation and robots and the like is considered as an effective method for solving the pain point of the spinal column positioning operation because the intelligent equipment has high operation precision and can fuse medical images to provide multi-mode operation information for doctors, but the robot technologies facing the positioning operation can not meet the clinical requirements of the spinal column laminectomy operation; secondly, during the decompression operation, the external shape of the rigid tissues such as the vertebral body and the like changes, and the external shape and the relative position of the soft tissues such as the nerve and the like also change, so that the positioning robot under the guidance of the image cannot recognize and correct the changes. Therefore, there is a need for a respiratory follow-up laminectomy instrument that moves synchronously with the movement of the cone during breathing to accurately perform laminectomy and ensure that the underlying spinal cord/nerve is not damaged. Disclosure of Invention The invention aims to provide an ultrasonic surgical instrument for laminectomy, which solves the problems in the prior art, can realize breathing follow-up when a patient breathes to cause the fluctuation of a vertebral body, accurately completes the cutting of a vertebral plate, and ensures that spinal cord/nerves under the vertebral plate are not damaged. In order to achieve the above object, the present invention provides the following solutions: the invention provides a laminectomy ultrasonic surgical instrument, which comprises a handle, an ultrasonic shell, an ultrasonic bone knife assembly and a follow-up sleeve, wherein the handle is connected to the bottom of the ultrasonic shell, the follow-up sleeve is connected to the front end of the ultrasonic shell and is used for being abutted against a vertebral plate to move synchronously with the vertebral plate, the ultrasonic bone knife assembly comprises an ultrasonic knife handle and a bone knife connected to one end of the ultrasonic knife handle, the ultrasonic knife handle is arranged in the ultrasonic shell, the bone knife is arranged in the follow-up sleeve, a driving mechanism for driving the ultrasonic bone knife assembly to move linearly in a reciprocating mode is arranged in the ultrasonic shell, and when the follow-up sleeve is abutted against the vertebral plate, the driving mechanism drives the ultrasonic bone knife assembly to extend out of the follow-up sleeve to cut the vertebral plate. Preferably, a locking mechanism is arranged in the ultrasonic shell, the ultrasonic knife handle is arranged on the locking mechanism, the locking mechanism comprises a locking fixing piece, a locking movable piece and a locking adjusting mechanism, the locking movable piece is connected to the locking fixing piece in a sliding mode, a first clamping piece is arranged on the locking movable piece, a second clamping piece corresponding to the first clamping piece is arranged on the locking fixing piece, the locking adjusting mechanism is connected with the locking movable piece and the locking fixing piece and used for adjusting the distance between the locking movable piece and the locking fixing piece, so that the first clamping piece and the second clamping piece are close to each other to clamp the ultrasonic knife handle, or the first clamping piece is far away from the second clamping piece to loosen the ultrasonic knife handle, the locking fixing piece is connected with the driving mechanism, and the driving mechanism drives the locking mechanism to reciprocate to linearly move so as to drive the ultrasonic knife assembly to reciprocate to linearly move. Preferably, the locking adjustment m