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CN-122028852-A - Instrument for orbital endoscopic surgery

CN122028852ACN 122028852 ACN122028852 ACN 122028852ACN-122028852-A

Abstract

An instrument for use in transorbital endoscopic surgery is presented. The instrument includes a handle, a support element movably attached at one end to the support element, first and second arms, each including a fixed portion connecting the arms to the support element and an anchor portion releasably attached to the fixed portion, one of the anchor portions configured to anchor to a first fracture of the orbital cavity and the other of the anchor portions configured to anchor to a second fracture of the orbital cavity, each of the anchor portions having a given curvature, a mesh disposed between the anchor portions and connected to each of the anchor portions to gather periorbital tissue when the anchor portions are anchored to the first and second fractures, and a sensor for detecting an applied pressure applied to the first and second fractures.

Inventors

  • A. Disoma
  • J. Enseniat
  • G. Trias
  • M. GARCIA
  • J. Matas
  • A. Platts

Assignees

  • 巴塞罗纳医院门诊部
  • 巴塞罗那临床研究基金会-奥古斯特·皮·松耶尔生物医学研究所
  • 巴塞罗纳大学

Dates

Publication Date
20260512
Application Date
20240923
Priority Date
20230927

Claims (14)

  1. 1. An instrument for transorbital endoscopic surgery, comprising: A handle (10); -a support element (11), the handle (10) being movably attached at one end to the support element (11); -a first arm (20) and a second arm (30), each arm comprising a fixed portion (21, 31) connecting the arm to the support element (11) and an anchoring portion (22, 32) releasably attached to the fixed portion (21, 31), one of the anchoring portions (22, 32) being configured to anchor to a first fissure of the orbital cavity and the other of the anchoring portions (22, 32) being configured to anchor to a second fissure of the orbital cavity, each of the anchoring portions (22, 32) comprising a given curvature; A mesh (40) disposed between the anchor portions (22, 32) and connected to each of the anchor portions (22, 32) to gather periorbital portions when the anchor portions (22, 32) are anchored to the first and second fissures, and A plurality of sensors configured to detect pressure applied to the first and second fractures when the mesh (40) is gathering orbit Zhou Shishi.
  2. 2. The apparatus of claim 1, wherein the plurality of sensors are arranged throughout the mesh (40) such that the mesh (40) is a sensorized mesh.
  3. 3. The instrument of claim 1, wherein the plurality of sensors are disposed on the anchor portion (22, 32).
  4. 4. The apparatus according to any of the preceding claims, wherein at least one of the fixation portions (21, 31) further comprises a movement mechanism (50) configured to allow a controlled reciprocal telescopic movement of the anchoring portion (22, 32).
  5. 5. The instrument of claim 4, wherein the movement mechanism (50) comprises a guide (51) and a sliding mechanism (52) configured to slide via the guide (51).
  6. 6. An instrument according to any of the preceding claims, wherein the handle (10) comprises a pivoting element (15) at its end connected to the support element (11).
  7. 7. The instrument of any one of the preceding claims, wherein the handle (10) further comprises a push button (9) configured to enable the handle (10) to be rotated along at least one axis from an initial position to a final position, such that an angle between the handle (10) and the first arm (20) and the second arm (30) can be up to 180 ° when the handle (10) is in the final position.
  8. 8. The device according to any one of the preceding claims, wherein the support element (11) further comprises a toothed control wheel (13) for opening and closing the first arm (20) and the second arm (30).
  9. 9. The device according to any one of the preceding claims, wherein the support element (11) further comprises a push button (12) configured to abruptly close the first arm (20) and the second arm (30) using a braking mechanism (18) and a worm gear arrangement (17).
  10. 10. The device according to any of the preceding claims, wherein the mesh (40) comprises a biocompatible material or coating.
  11. 11. The device of claim 10, wherein the biocompatible material comprises at least one polymer.
  12. 12. The apparatus of any preceding claim, wherein the plurality of sensors are configured to communicate the detected pressure to a computer device.
  13. 13. The apparatus according to any of the preceding claims 1-9, wherein the plurality of sensors are configured to transmit the detected pressure to a communication module comprised within the support element (11).
  14. 14. The device according to any one of the preceding claims, wherein the first arm (20) and the second arm (30) are made of stainless steel.

Description

Instrument for orbital endoscopic surgery Technical Field The present invention relates to an instrument/device for transorbital endoscopic surgery. Background Transorbital endoscopic surgery is a minimally invasive surgical technique that involves accessing the skull and orbital regions via the orbital (orbit) by using an endoscope and specialized instruments. This method is used to treat various conditions and lesions in the skull base, sinuses and orbit. Transorbital endoscopic surgery is considered minimally invasive because it involves making small incisions in the eyelid to access the surgical site. This approach reduces the need for extensive tissue dissection, thereby reducing trauma to surrounding structures and shortening recovery time. In addition, it is used to treat a wide range of conditions including complex skull base tumors (benign or malignant), cysts, vascular abnormalities, inflammatory diseases and congenital abnormalities in the skull base, sinuses and orbit. Advantages of transorbital endoscopic surgery over traditional open surgical methods include reduced scarring, shorter hospital stays, and faster recovery. It also minimizes the risk of damage to the critical structure. To reach the skull base, one of the first operations is to displace the orbital contents. Currently, surgeons use deformable uncontrolled retractors to achieve this goal. Moreover, during surgery, the optic nerve is subjected to pressure that may damage it, and the only way to measure pressure is currently the diameter of the pupil, which requires stopping the surgery and does not allow to prevent visual damage. Thus, there is a need for new and improved instruments/devices for transorbital endoscopic surgery, particularly in connection with orbital content displacement, in order to reach the skull base. Disclosure of Invention It is therefore an object of the present invention to provide a new instrument/device for orbital endoscopic surgery that can move orbital contents aside once an incision is made. This is necessary to create a highly desirable working space and introduce surgical instruments therethrough. Furthermore, the proposed instrument allows measuring intraocular pressure without stopping the operation, and can prevent an increase in orbital pressure that may cause postoperative visual impairment. To this end, according to one aspect, the invention proposes an instrument for orbital endoscopic surgery comprising a handle, a support element movably attached at one end to the support element, a first arm and a second arm, each arm comprising a fixed portion connecting the arms to the support element and an anchor portion releasably attached to the fixed portion, one of the anchor portions being configured to anchor to a first cleft of an orbital cavity, in particular, an inferior orbital cleft (i.e. a very constant and relevant anatomical landmark for orbital surgery of an endoscope of the skull base), and the other of the anchor portions being configured to anchor to a second cleft of an orbital cavity, in particular, an superior orbital cleft (i.e. a second and very constant anatomical landmark for orbital surgery of an endoscope of the skull base), each anchor portion comprising a given curvature, a mesh arranged between and connected to each of the anchor portions to gather at the first and second cleft, and a sensor for application to the first and second sensor when gathering. According to the invention, the at least one fixation section further comprises a movement mechanism configured to allow a controlled back and forth telescopic movement of its respective anchoring section. In some particular embodiments, both fixed portions include a movement mechanism. In some embodiments, the sensors are arranged on the web such that the web is a sensorized (sensorized) web. Alternatively, in other embodiments, the sensor is arranged on the anchoring portion. Even in some embodiments, the sensor may be disposed on both the mesh and the anchor portion. In some embodiments, the movement mechanism includes a guide and a sliding mechanism configured to slide via the guide. In some embodiments, the handle includes a pivot element at one end thereof connected to the support element. In some embodiments, the handle further comprises a push button to enable the handle to be rotated along at least one axis from an initial position to a final position such that the angle between the handle and the first and second arms may be up to 180 ° when the handle is in the final position. In some embodiments, the support element further comprises a toothed control wheel for opening and closing the first arm and the second arm. In some embodiments, the support element is further equipped with a push button designed to abruptly/immediately close both the first arm and the second arm. This function is achieved by the coordinated action of the push button with an integrated braking mechanism and worm gear within the support eleme