Surgical instrument set for use during unilateral biportal endoscopy

Abstract

Disclosed is a method of unilateral biportal endoscopy and a surgical instrument set used in the same. More particularly, the present invention relates to a method of unilateral biportal endoscopy which separately secures a working portal for surgical instruments and an endoscopic portal for an endoscope, thereby providing a more accurate spinal surgery, and to a surgical instrument set which can be effectively applied to the method.

1 - 5 . (canceled) 
     
     
         6 . A surgical instrument set used in unilateral biportal endoscopy, the surgical instrument set comprising:
 a plurality of enlarging tubes having different diameters and configured to form two separate passageways including a working portal and an endoscopic portal that extend to a surgical site for progression of bidirectional vertebral endoscopic surgery;   a muscle detacher comprising a blade portion and a handle portion, configured to detach a muscle from bone at the surgical site by being inserted into one of the pathways secured by the enlarging tubes;   a root retractor comprising a first curved portion at a center of the root retractor and a second curved portion at an end of the root retractor configured to retract the muscle separated from the bone by the muscle detacher and to secure an additional working space and a grooved portion having a curvature facing opposite to a direction of curvature of the first curved portion; and   an endoscope configured to be inserted into the body through a remaining one of the pathways secured by the enlarging tubes and to capture an image of the surgical site.   
     
     
         7 . The surgical instrument set of  claim 6 , further comprising:
 a double ended retractor comprising a handle portion located between two opposite tip portions located at each end of the retractor and configured to be inserted into a space created by the muscle detacher and to detach a nerve root from bone or ligamentum flavum.   
     
     
         8 . The surgical instrument set of  claim 6 , further comprising:
 a bone chip cannula provided with a collecting portion configured for collecting and concentrating bone chips supplied from outside, and a guide tube portion connected to the collecting portion and extending in a lengthwise direction thereof, the guide tube portion configured to guide the bone chips to a disc in a state of reaching the surgical site through one of the pathways; and   a bone chip impactor comprising a tip portion at a front end and a handle portion at an end opposite of the tip portion configured for impacting on the bone chips guided to a disc space such that the bone chips are seated in the disc.   
     
     
         9 . The surgical instrument set of  claim 6 , further comprising:
 a radiofrequency probe configured for heating and removing a target tissue located at the surgical site after reaching the surgical site in the body through the working portal.   
     
     
         10 . The surgical instrument set of  claim 9 , wherein the radiofrequency probe comprises:
 an insertion rod configured for insertion into the body through the working portal so as to reach the surgical site;   an electrode tip provided at a front end of the insertion rod and configured for outputting radiofrequency heat when supplied with electric power; and   a safety protrusion formed on a surface of the electrode tip and configured for separating the surface of the electrode tip from tissue to prevent thermal damage to the tissue.   
     
     
         11 . The surgical instrument set of  claim 20 , wherein the K-punch comprises:
 an entry rod configured for insertion into the body through the working portal so as to reach the surgical site and having a retaining step portion a front end of the entry rod;   a slider slidably engaged with the entry rod and configured for moving forward and backward with respect to the retaining step portion;   a rotary shaft fixed to a rear side of the entry rod and configured for rotation by manipulation of an operator to control a direction of the retaining step portion;   a pushing rod fixed at aits front end to the slider and extending from a rear end of the slider to a rear side of the rotary shaft; and   a handle portion configured for moving the pushing rod forward such that the slider is pressed and moved toward the retaining step portion.   
     
     
         12 . The surgical instrument set of  claim 21 , wherein the round drill comprises:
 an outer tube having a predetermined diameter and extending in a lengthwise direction, the outer tube configured for reaching the surgical site through one of the pathways and having an opening inclined at a front end thereof to have an acute angle with respect to the lengthwise direction of the outer tube;   a tube holder fixed to a rear end of the outer tube; and   a drill body including a burr exposed to outside of the outer tube and on which diamond powder is distributed.   
     
     
         13 . The surgical instrument set of  claim 6 , wherein the endoscope comprises:
 a hollow tube-shaped guide tube extending to reach at a first end thereof the surgical site in the body through one of the pathways during use, the guide tube configured for accommodating a probe of an endoscope camera;   a saline solution guiding portion provided at a rear end of the guide tube and configured for guiding a saline solution injected from outside into the guide tube, the saline solution guiding portion including a valve body fixed to the rear end of the guide tube and allowing the saline solution to pass therethrough and move to the guide tube, and a flow control valve provided at the valve body and configured for controlling the saline solution passing through the valve body; and   an adapter portion provided at the rear end of the guide tube and configured for guiding the probe of the endoscope camera to the guide tube.   
     
     
         14 . The surgical instrument set of  claim 13 , wherein a damping chamber is provided between the valve body and the guide tube, the damping chamber configured for receiving and storing the saline solution passing through the valve body and guiding the saline solution to the guide tube. 
     
     
         15 . The surgical instrument set of  claim 14 , wherein a plurality of valve bodies is provided on an outer circumferential surface of the damping chamber whereby a supply amount of the saline solution to the damping chamber can be increased. 
     
     
         16 . The surgical instrument set of  claim 13 , wherein the guide tube is provided on an inner circumferential surface thereof with a linear guide groove extending in the lengthwise direction of the guide tube and is configured for guiding the saline solution introduced in the guide tube in the lengthwise direction of the guide tube, such that the saline solution reaches a lens provided at a front end of the probe of the endoscope camera. 
     
     
         17 . The surgical instrument set of  claim 16 , wherein a plurality of linear guide grooves is arranged on the inner circumferential surface of the guide tube in a circumferential direction thereof, and a supporting protrusion is provided between each linear guide groove and an adjacent linear guide groove, the supporting protrusion being in contact with the probe of the endoscope camera. 
     
     
         18 . The surgical instrument set of  claim 13 , wherein the guide tube is provided at a front end thereof with a projecting portion and a depressed portion that are repeatedly provided in a wave pattern in a circumferential direction of the guide tube and are configured to guide the saline solution discharged from the guide tube to flow out in a radial direction of the guide tube. 
     
     
         19 . The surgical instrument set of  claim 13 , wherein the guide tube is provided with a side slit formed on a side of a front end of the guide tube and the side slit is configured for discharging the saline solution discharged from the guide tube to a side of the guide tube. 
     
     
         20 . The surgical instrument set of  claim 6 , further comprising a K-punch configured for physically detaching and removing target tissue after reaching the surgical site in the body through the working portal. 
     
     
         21 . The surgical instrument set of  claim 6 , further comprising a round drill configured for grinding bone located at the surgical site after reaching the surgical site through the working portal. 
     
     
         22 . The surgical instrument set of  claim 6 , further comprising a sheath mechanism provided with a guide tube configured to control the direction of a saline solution during the unilateral biportal endoscopy. 
     
     
         23 . The surgical instrument set of  claim 6 , wherein the guide tube comprises a plurality of projections and a plurality of depressed portions at a front end which are configured to control the direction of a saline solution during the unilateral biportal endoscopy.