WO2004006784A1

WO2004006784A1 - Surgical saw system for non-dissection type osteotomy through stab incision

Info

Publication number: WO2004006784A1
Application number: PCT/KR2003/001364
Authority: WO
Inventors: Hee-Young Lee
Original assignee: Hee-Young Lee
Priority date: 2002-07-11
Filing date: 2003-07-09
Publication date: 2004-01-22
Also published as: KR20020065440A; AU2003247173A1; KR100505131B1

Abstract

Disclosed is a surgical saw system for use in non-dissection type osteotomy through a stab incision comprising a surgical saw (10) having a rod (11) with a thin and long shape and a saw blade (12) formed at the front end of the rod (11), and a supplementary device. The supplementary device includes a saw guide tube (20) provided with an inner space for receiving and operating the saw blade (12), and a guide rod (30) serving to remove periosteum and to guide the saw guide tube (20) into a cutting site.

Description

SURGICAL SAW SYSTEM FOR NON-DISSECTION TYPE OSTEOTOMY THROUGH STAB INCISION

Technical Field

The present invention relates to a surgical saw system for use in reduction surgery of a facial bone such as a zygoma or nasal bone, and more particularly to a surgical saw system for use in non-dissection type osteotomy of a facial bone through a stab incision comprising a surgical saw provided with a saw blade formed at the front end of a thin and long rod, a saw guide tube providing a space for operating the saw blade and guiding the surgical saw to a cutting site of the facial bone, and a guide rod provided with a sharpened blade formed at its one end and a passage for transferring the saw guide tube to the cutting site and used to remove periosteum.

Background Art

Generally, a zygoma denotes a check bone of a face. A zygoma fracture and reduction surgery is performed to reduce the zygoma into a desired size and shape.

In the zygoma fracture and reduction surgery, a body of the zygoma is completely cut at a designated position and a posterior portion of a zygomatic arch is incompletely cut. Then, the body of the zygoma is pressed so that the posterior portion is incompletely fractured. The zygoma fracture and reduction surgery has a complicated procedure, and is very dangerous.

In order to cut the body of the zygoma, a stab incision with a size of 4cm is made at a designated site within an oral cavity so that the zygoma is completely exposed to the outside via the stab incision. Since a conventional electric-powered saw blade has a large width, the conventional electric-powered saw blade contacts peripheral tissues during a surgical operation at a small site, thus causing operational malfunction and damaging the peripheral tissues. In order to incompletely cut a zygomatic arch, a preauricular incision is performed so as to expose the zygomatic arch. Then, a designated portion oi^' the exposed zygomatic arch is cut using an osteotome or a partial rotation type oscillating saw. The cutting amount of the zygomatic arch is adjusted only by the surgeon's hands and skill.

Since the incision within the oral cavity in the zygoma fracture and reduction surgery causes bleeding and nerve injury, and the preauricular incision damages facial nerves and vessels, the zygoma fracture and reduction surgery is dangerous and requires a long time for performing incision and suture.

Accordingly, the zygoma fracture and reduction surgery essentially requires general anesthesia, and causes a problem of long lasting post operative swelling.

It is preferable to cut the facial bone through a minimum incision. However, in order to assure a required operation space and approximate a saw to a cutting site, the incision essentially has a constant size suitable to insert the saw into the cutting site. Thus, any method using a smaller incision has not been proposed.

Further, a nasal bone cut surgery for cutting the side surface of a nasal bone is performed using an osteotome through a stab incision. Such a nasal bone cut surgery also damages the mucous membrane of the nasal tissue by means of the sharpened tip of the osteotome.

Occasionally, a linearly reciprocating saw was used to cut a facial bone. However, since this reciprocating saw also requires a long time to expose the surface of the facial bone to the outside, the linearly reciprocating saw is rarely- used now.

Disclosure of the Invention

Therefore, the present invention has been made in view of the above problems, and it is an object of the present invention to provide to a surgical saw system for simply performing osteotomy of a facial bone, thus decreasing the risk of medical accidents and allowing a surgeon to safely and easily perform the osteotomy via a simple procedure.

In accordance with the present invention, the above and other objects can be accomplished by the provision of a surgical saw system, which minimizes a stab incision so that bleeding and nerve injury is prevented, and allows a surgeon to precisely and easily to cut a designated portion of a facial bone, thus minimizing the surgeon's effort.

Preferably, the surgical saw system may comprise a surgical saw, a saw guide tube, and a guide rod.

The surgical saw includes a rod with a thin and long shape, and a saw blade formed at the front end of the rod. The saw guide tube is formed to have a thin cylindrical shape with a space receiving the surgical saw inserted thereinto. After the saw guide tube is inserted into a cutting site of a designated bone of a human body, the surgical saw is inserted into the saw guide tube so that the saw blade of the surgical saw contacts and cuts the cutting site.

The saw blade of the surgical saw may be replaced with a screw thread or a file. Preferably, the cylindrical saw guide tube provided with the space receiving the surgical saw may include a cut limiter formed at its one end. The cut limiter serves to adjust the cut depth of the saw blade. Further, preferably, the saw guide tube may further include a suction tube and a saline solution feeding tube, which are inserted thereto. Alternatively, the saw guide tube may further include an independent space serving to suck cut bone debris and feed a saline solution therethrough.

Further, the guide rod may include a small through hole, and serve to guide the saw guide tube to a desired site within the human body and remove periosteum. After a small stab incision is formed through a cutting site of the human body, the saw guide tube is inserted into the stab incision and approaches the cutting site. Under this condition, the surgical saw is inserted into the saw guide tube, and then cuts a desired portion of a bone. Compared to the conventional surgical saw for cutting a bone through a large stab incision, the surgical saw system of the present invention cuts the desired portion of the bone through a small stab incision. Further, since the saw blade of the surgical saw system of the present invention is operated within the saw guide tube, the surgical saw system of the present invention reduces risks such as nerve injury, soft tissue injury, etc.. allows even an unskilled surgeon to safely and easily perform osteotomy of a facial bone, and remarkably shortens the operation time and the period of convalescence after the osteotomy.

Brief Description of the Drawings

The above and other objects, features and other advantages of the present invention will be more clearly understood from the following detailed description taken in conjunction with the accompanying drawings, in which:

Fig. 1 is a schematic view of a surgical saw in accordance with one embodiment of the present invention; Fig. 2 is a schematic view of a surgical saw in accordance with a further embodiment of the present invention;

Fig. 3 is a schematic view of a surgical saw in accordance with another embodiment of the present invention;

Fig. 4 is a schematic view of a saw guide tube of the surgical saw; Figs. 5a to 5c are schematic views of a saw guide tube provided with saline solution feeding means and bone debris suction means;

Fig. 6 is a schematic view of a saw guide tube provided with a cut limiter;

Figs. 7a and 7b are schematic views of the operating principle of the cut limiter; Fig. 8 is a schematic view of a guide rod;

Figs. 9a and 9b are schematic views illustrating the usage of the surgical saw and the saw guide tube in accordance with the present invention;

Figs. 10a to 10c are schematic views comparatively illustrating cutting sites and cutting amounts using the surgical saw of the present invention and a conventional surgical saw during osteotomy of a facial bone; and

Fig. 1 1 is a schematic view of a conventional surgical saw.

Best Mode for Carrying Out the Invention

Now, preferred embodiments of the present invention will be described in detail with reference to the annexed drawings. Fig. 1 illustrates a surgical saw 10 in accordance with one embodiment of the present invention. The surgical saw 10 comprises a rod 1 1 with a thin and long shape, and a saw blade 12 formed at an end of the rod 11.

The rod 1 1 is used as a support of the saw blade 12, and provides a space to be connected to a powered surgical handpiece and a hand-operated knob. Further, the rod 1 1 serves to insert the saw blade 12 into a deep site of a region of a human body. The saw blade 12 serves to cut a bone by means of its linear reciprocating motion.

Preferably, the rod 1 1 has a length of 100-200mm, The saw blade 12 formed at the end of the rod 1 1 has a length of 30-40uιm, and a thickness of 0.8- 1 .2iiiiii. A back 13 of the saw blade 12 has a width of 2-4ιιιm.

The rod 1 1 is connected to the powered surgical handpiece and the knob used in hand-powered cutting, thus allowing the saw blade 12 to approach the deep site of the region of the human body. The rod 11 is made of a cylindrical or square body with a diameter of 2-4ιιιιιι, and has a length of 100-200muι in consideration of an operative site, an operative method and a space for operating the surgical saw 10 using the powered surgical handpiece.

Since a body of the zygoma or a side surface of the nasal bone has a width of approximately 30 mm. the saw blade 12 has a length larger than the above width so as to effectively cut the body of the zygoma or the side surface of the nasal bone, and preferably has a length of 30-40mnι.

The thickness of the saw blade 12 and the width of the saw back 13 affect the cutting intensity of the saw blade 12. In order to strengthen the cutting intensity of the saw blade 12 weakened by minimizing the width of the saw back

13 so that the saw blade 12 is inserted into a thin tube, the saw blade 12 has a thickness of 0.8-1.2 mm, larger than the thickness of a general surgical saw, and the saw back 13 has a width of 2 -4mm.

The surgical saw 10 is produced by a cutting or forging procedure so that the surgical saw 10 with a length of 30-40mm and a thickness of 0.8-1.2mm, and processed to have a parabolic shape. Then, the saw blade 12 is produced by forming saw teeth with a length of 0.8-1.2mm at the lower surface of the surgical saw 10.

As shown in Figs. 2 and 3, instead of the saw blade 12, the surgical saw 10 may comprise a screw thread 14 or a file 15 at the end of the rod 1 1. The screw thread 14 and the (lie 15 are thin enough to cut a desired site of the bone the same as the saw blade 12. if necessary, to grind a desired site of the bone.

The above-described surgical saw 10 is connected to the powered surgical handpiece provided with linearly reciprocating means, thus being capable of approaching deep surgical sites of the human body so as to cut a designated portion of the bone.

The surgical saw 10 of the present invention is discriminated from a conventional surgical saw in terms of the below respects.

Since a conventional surgical linear saw (with reference to Fig. 1 1) has a small thickness of 0.4-0.6 mm. the conventional surgical linear saw must have a large width of 6-lOιιιιn so as to maintain the intensity required to cut a bone.

Accordingly, it is difficult to allow the conventional surgical linear saw to approach the inside of a tissue of the human body through a small stab incision.

Further, in case that the conventional surgical linear saw uses a tube with a large diameter, the large diameter of the used tube causes difficulty in reducing the size of the stab incision.

In case that the conventional surgical linear saw uses the tube, a supporter of the saw has a diameter much smaller than that of the tube. Accordingly, the supporter within the tube is heavily agitated during the operation of the saw, thus causing difficulty in stably operating the conventional surgical linear saw.

However, the surgical saw of the present invention has the small width (2-

4ιιιιi]) of the saw back and the large thickness (0.8-1.2mm) of the saw blade, and comprises the saw blade and the rod integrated with the saw blade. A small-sized tube is put into a tissue of the human body, and then the surgical saw of the present invention is inserted into the tube. Accordingly, the surgical saw of the present invention can approach to an operative site without any contact with peripheral tissues.

Fig. 4 illustrates an example of a saw guide tube 20 in accordance with the present invention. The saw guide tube 20 has a cylindrical shape with an inner diameter of 3-όuιm and an outer diameter of 4-7uιιn. The length of the saw guide tube 20 is a little smaller than the total length of the surgical saw.

The saw guide tube 20 has an inner space for allowing the surgical saw to be freely inserted thereinto, and serves to guide the surgical saw to a cutting site and to provide a space for movement of the surgical saw. Further, the saw guide tube 20 serves to protect peripheral tissues from the operation of the surgical saw.

Fig. 5a illustrates the saw guide tube 20 including a suction tube 51 and a saline solution feeding tube 61, which are located within the saw guide tube 20.

Fig. 5b illustrates the saw guide tube 20 including a suction tube 21 and a saline solution feeding tube 22. which are connected from the inside of the tube 20 to the front end of the tube 20. Fig. 5c illustrates the saw guide tube 20 with a double tube structure, in which a suction portion 23 and a saline solution feeding portion

24 are obtained between inner and outer tubes of the saw guide tube 20.

The above-described suction means and saline solution feeding means are respectively connected to an external suction unit 50 and an external saline solution feeding unit 60, thereby sucking bone debris generated in cutting bone and discharging the sucked bone debris to the outside, and removing heat generated in cutting bone. Accordingly, it is possible to effectively cut a bone and to suck the bone debris generated in cutting the bone.

Fig. 6 illustrates a cut limiter 25 formed at the front end of the above- described saw guide tube 20. The cut limiter 25 is obtained by cutting the lower portion of the front end of the saw guide tube 20 along a parabolic line, thereby exposing the saw blade of the surgical saw inserted into the saw guide tube 20. Here, the length of the saw blade exposed from the cutting line of the cut limiter 25 to the outside is adjusted by rotating the saw guide tube 20 at a proper angle. That is. as shown in Fig. 7a, when the cut limiter 25 of the saw guide tube

20 is located just above the saw blade of the surgical saw inserted into the saw- guide tube 20. the distance between the side surface 25a of the cut limiter 25 and the saw blade is a cutting depth (D) of a bone using the saw blade. Then, when the saw guide tube 20 moves back so that the saw blade is entirely exposed from the cutting line of the cut limiter 25 to the outside, the saw blade can cut a desired site more deeply. As shown in Fig. 7b, by slightly rotating the saw guide tube 20 so that the side surface 25a of the saw guide tube 20 is close to the saw blade, a cutting depth (Dl and D2) of the bone using the saw blade can be freely adjusted, thus finely adjusting the cutting depth of the saw blade. Preferably, an end of the saw guide tube 20 is enlarged and serves as a connection portion 25b connected to the powered surgical handpiece so that the saw guide tube 20 provided with the cut limiter 25 is fixed to the main body of the powered surgical handpiece. Further, preferably, a scale mark 25c is formed on the outer surface of the connection portion 25b, thereby allowing an external viewer to check a slope degree of the saw guide tube 20.

Fig. 8 illustrates an example of a guide rod 30 in accordance with the present invention. The guide rod 30 is formed to have a cylindrical shape, and includes a hemispherical blade 31 located at the front end of the guide rod 30. The guide rod 30 has an outer diameter smaller than the inner diameter of the saw guide tube, and an inner diameter of 2-4mm, similar to the diameter of the rod of the surgical saw.

The guide rod 30 serves to remove periosteum or to guide the saw guide tube 20 (Fig. 4) to a cutting site. For example, in case that a zygomatic bone is cut, a small stab incision is formed through a designated site within an oral cavity. and the guide rod 30 is inserted into a cutting region through the stab incision. After the periosteum is removed using the guide rod 30, the saw guide tube 20 is guided along the external surface of the guide rod 30 so that the front end of the saw guide tube 20 approaches the cutting region.

The surgical saw of the present invention can be used independently, or together with the saw guide tube. Further, the surgical saw of the present invention can be used together with the saw guide tube and the guide rod.

As shown in Figs. 9a and 9b, the surgical saw 10 of the present invention is used under the condition that the surgical saw 10 is connected to a powered surgical handpiece 70 provided with linearly reciprocating means or a simple knob 80. Here, a user grips the saw guide tube 20 with his/her one hand, and inserts the surgical saw 10 connected to the powered surgical handpiece 70 into the saw- guide tube 20 with his/her other hand. Thereby, the saw blade 12 (Fig. 1) is exposed from the saw guide tube 20 to the outside, and then used to cut a designated site of a bone. Hereinafter, a surgical procedure using the above surgical saw of the present invention will be described.

First, a stab incision is made at a designated site of skin using the guide rod or a surgical blade.

Second, the guide rod is inserted into a bone cutting site through the stab incision, and then manipulated to remove periosteum of the bone cutting site.

Third, the saw guide tube is put on the guide rod inserted into the bone cutting site so that the saw guide tube is guided to the bone cutting site, and then only the guide rod is separated from the bone cutting site.

Fourth, the surgical saw connected to the surgical powered handpiece is inserted into the saw guide tube and then operated to cut a designated portion of the bone cutting site.

Figs. 10a and 10b comparatively illustrates cutting sites and cutting amounts using the surgical saw of the present invention and a conventional surgical saw. As shown in Fig. 10b in which the conventional surgical saw having a saw back with a large width is used, two stab incisions (Cl and C2) with a large width are made on facial skin above a zygomatic bone. However, as shown in Fig. 10b in which the surgical saw of the present invention is used, a small stab incision (C) with a size suitable for inserting the saw guide tube into a cutting site therethrough is made at a designated portion within an oral cavity, and the insertion direction of the saw guide tube is changed through the stab incision (C). Accordingly, with the surgical saw of the present invention, it is possible to form a complete fracture 101 and an incomplete fracture 102 at a zygomatic arch via one stab incision (with reference to Fig. 10c).

As shown in Fig. 10c, the incomplete fracture 102 is bent into the zygomatic bone by pressing the complete fracture 101, thus being produced as a bending portion E. A desired contouring of the zygomatic bone can be obtained by grinding a desired portion of the zygomatic bone using the surgical saw provided with the above-described screw thread or file.

Industrial Applicability

As apparent from the above description, the present invention provides a surgical saw system for used in osteotomy of a facial bone such as a zygoma or nasal bone, which comprises a reciprocating saw blade inserted into a small tube so that the saw approaches a cutting site of the facial bone. The surgical saw- system of the present invention is not limited to the above-described structures of the saw. the saw guide tube and the guide rod, but may be variously modified.

Since the saw blade, which linearly reciprocates, is inserted into the saw guide tube, the surgical saw system of the present invention allows a surgeon to perform a reduction surgery of a facial bone such as a zygoma or nasal bone through a stab incision. The operative method using the surgical saw system of the present invention allows the surgeon to conveniently perform plastic surgery and other improved surgery, and removes a possibility of side effects due to complication after surgical operation, such as nerve injury and soft tissue injury. Further, the operative method using the surgical saw system of the present invention shortens the operation time and effort, thus being very effective in plastic surgery.

Although the preferred embodiments of the present invention have been disclosed for illustrative purposes, those skilled in the art will appreciate that various modifications, additions and substitutions are possible, without departing from the scope and spirit of the invention as disclosed in the accompanying claims.

Claims

Claims:

1 . A surgical saw for use in non-dissection type osteotomy through a stab incision comprising: a rod with a thin and long shape; and a saw blade, formed at the front end of the rod, having a thickness of 0.8-

1.2mm, a height of 2-4mm from the saw blade to a saw back, and a length of 30- 40mm. and wherein the surgical saw is inserted into a cutting site through the stab incision and used to cut a designated site of a facial bone such as a zygoma or nasal bone.

2. The surgical saw as set forth in claim 1, wherein a file is formed at the saw blade at the front end of the rod.

3. A supplementary device of a surgical saw for use in non-dissection type osteotomy through a slab incision, comprising a saw guide tube formed to have a cylindrical shape with an inner diameter of 3-6mm and an outer diameter of 4-7mm, and used to guide the surgical saw as set forth in claim 1 to a cutting site while inserting the surgical saw into the saw guide.

4. The supplementary device as set forth in claim 3, wherein the saw guide tube includes saline solution feeding means formed therein.

5. The supplementary device as set forth in claim 3, wherein a cut limiter is formed at the front end of the saw guide tube by cutting and removing the lower portion of the front end of the saw guide tube along a parabolic line.

6. A supplementary device of a surgical saw for use in non-dissection type osteotomy through a stab incision, comprising a guide rod with an outer diameter of 2-41I1U1 provided with a hemispherical blade formed at a front end of the guide rod. and used to guide the saw guide tube as set forth in claim 3 to a cutting site and to remove periosteum at the cutting site.