A cavity retaining tool for bone surgery, a cavity retaining tool for general surgery, an endoscopic surgery system involving the use of a cavity retaining tool, and a procedure for surgery

Claim 2

A cavity-retaining tool for bone surgery according to Claim 1 in which the fitting means are provided with a bone fitting segment which allows the tip of the cavity-retaining sheath to fit faithfully to the shape of a bone.

Claim 3

A cavity-retaining tool for bone surgery according to Claim 2 in which the bone fitting segment takes a shape to fit faithfully to the shape of a bone.

Claim 4

A cavity-retaining tool for bone surgery according to Claim 3 in which the bone fitting segment takes a shape to fit faithfully to the shape of the posterior aspect of a vertebral body and the vertebral arch.

Claim 5

A cavity-retaining tool for bone surgery according to Claim 4 in which the bone fitting segment has a tip whose shape fits faithfully to the contour of a bone.

Claim 6

A cavity-retaining tool for bone surgery according to Claim 5 in which the bone fitting segment has a tip which is shaped like an inclined surface.

Claim 7

A cavity-retaining tool for bone surgery according to Claim 4 in which the bone fitting segment has a tip which is provided with a lobular rejecting member.

Claim 8

A cavity-retaining tool for bone surgery according to Claim 3 in which the bone fitting segment has a shape to fit faithfully to the shape of a bone around the vertebral arch posterior to the vertebral body.

Claim 9

A cavity-retaining tool for bone surgery according to Claim 8 in which the bone fitting segment is constituted with a nearly cylindrical material, and a part of the wall of the cylindrical material protrudes from the tip.

Claim 10

A cavity-retaining tool for bone surgery according to Claim 8 in which the bone fitting segment is constituted with a nearly cylindrical material which is provided with a rejecting member extending towards the tip from a part of its wall.

Claim 11

A cavity-retaining tool for bone surgery according to Claim 2 in which the bone fitting segment is provided with a cavity expanding means by which to expand the internal cavity retained by the cavity-retaining sheath.

Claim 12

A cavity-retaining tool for bone surgery according to Claim 2 in which the bone fitting segment is provided with a deforming means by which to deform itself to fit faithfully to the shape of a bone to be fitted.

Claim 13

A cavity-retaining tool for bone surgery according to Claim 12 in which the deforming means is made of a rubber-like soft material.

Claim 14

A cavity-retaining tool for bone surgery according to Claim 12 in which the deforming means is made of an elastic material.

Claim 15

A cavity-retaining tool for bone surgery according to Claim 12 in which the deforming means is made of a material which can undergo deformation so as to fit faithfully to the shape of the bone to be fitted.

Claim 16

A cavity-retaining tool for bone surgery according to Claim 1 which further comprises: a core needle which is placed in the internal cavity of the cavity-retaining sheath, and acts as a support to facilitate the insertion of the cavity-retaining sheath into body tissues; an air-tightness retaining means which is placed in the internal cavity of the cavity-retaining sheath, and hermetically seals the gap with the cavity-retaining sheath; and an air-tight adapter which allows treatment tools to be introduced into the channel for treatment in an air-tight manner.

Claim 17

A cavity-retaining tool for bone surgery according to Claim 1 in which the channel for treatment is further comprising provided with a depth control means which controls the depth down to which a treatment tool is allowed to descend for treatment.

Claim 18

A cavity-retaining tool for bone surgery according to Claim 1 in which the observation means comprises a transparent member which is allowed to form at least part of the tip of the cavity-retaining sheath.

Claim 19

A cavity-retaining tool for bone surgery according to Claim 1 in which the observation means comprises: a scope channel instituted in the cavity-retaining sheath; and an endoscope which is inserted through the scope channel.

Claim 20

A cavity-retaining tool for bone surgery according to Claim 19 in which the cavity-retaining sheath has a channel for treatment which allows the insertion of tools necessary for bone treatment, and the scope channel and the treatment channel communicate directly or indirectly through an opening, with the internal passage of the cavity-retaining sheath

Claim 21

A cavity-retaining tool for bone surgery according to Claim 20 in which the fitting means is represented by an anchoring means implemented at the tip of the cavity-retaining sheath.

Claim 22

A cavity-retaining tool for bone surgery according to Claim 20 in which the anchoring means comprises: a spike channel prepared in the wall of the cavity-retaining sheath; and a spike which is driven into a bone after passing through the spike channel.

Claim 23

A cavity-retaining tool for bone surgery according to Claim 22 in which the tip of the spike channel communicates either with the scope channel or with the treatment channel, and is placed within the visual field of the endoscope.

Claim 24

A cavity-retaining tool for bone surgery according to Claim 22 in which the spike channel is shifted in position to one side in the cross-section of the sheath.

Claim 25

A cavity-retaining tool for bone surgery according to Claim 22 in which the spike channel, at least its part, lies in the wall of the cavity-retaining sheath.

Claim 26

A cavity-retaining tool for bone surgery according to Claim 22 in which the spike channel, at least its part, is placed close to the internal wall of the cavity-retaining sheath.

Claim 27

A cavity-retaining tool for bone surgery according to Claim 20 or 22 in which each of the channels has its own air-tight means.

Claim 28

A cavity-retaining tool for bone surgery according to Claim 20 in which the anchoring means is an anchoring member which is inserted into the channel for treatment, and comprises a stem which has a similar external diameter to the internal diameter of the treatment channel, and a needle member at the tip.

Claim 29

A cavity-retaining tool for bone surgery according to Claim 19 in which the scope channel has a fixing means by which to fix an endoscope at a desired position.

Claim 30

A cavity-retaining tool for bone surgery according to Claim 29 in which the fixing means is an O-ring.

Claim 31

A cavity-retaining tool for bone surgery according to Claim 1 in which the observation means is a hole for observation prepared on the wall of the sheath.

Claim 32

A cavity-retaining tool for bone surgery according to Claim 31 in which the observation hole is provided with a scope fitting means which fits the tip of a scope to the tip of the cavity-retaining sheath.

Claim 33

A cavity-retaining tool for bone surgery according to Claim 32 in which the scope fitting means is an elastic material

Claim 34

A cavity-retaining tool for bone surgery according to Claim 1 in which the cavity-retaining sheath has a duplicate structure comprising inner and outer sheaths.

Claim 35

A cavity-retaining tool for bone surgery according to Claim 34 in which the observation means, when observation windows are prepared on the tips of the inner and outer sheaths of the cavity-retaining sheath, consists of allowing, when the inner and outer sheaths are combined, the two observation windows to overlap.

Claim 36

A cavity-retaining tool for bone surgery according to Claim 35 in which at least either one of the windows prepared at the inner and outer sheaths is made of a transparent material.

Claim 37

A cavity-retaining tool for bone surgery according to Claim 34 in which the cavity-retaining sheath has an air-tight means between the inner and outer sheaths.

Claim 38

A cavity-retaining tool for bone surgery according to Claim 34 in which the cavity-retaining sheath has a fitting means at the tip of the inner sheath.

Claim 39

A cavity-retaining tool for bone surgery according to Claim 1 which has, in part of its wall, at least either of water feed channel or suction channel extending from the front end to the base end of the sheath.

Claim 40

A cavity-retaining tool for bone surgery according to Claim 1 comprises: a cavity-retaining sheath which is inserted into body tissues and maintains a work space for the treatment of a vertebral body by retaining a cavity; a treatment channel which is prepared in the sheath and guides tools for the treatment of a vertebral body and an implant into the work space for the treatment of a vertebral body; a fitting means which is placed at the tip of the sheath, and fits the sheath to a vertebral body; and an observation means which is placed in the sheath and by which to observe endoscopically the operation field within the work space for the treatment of a vertebral body.

Claim 41

A cavity-retaining tool for surgery which is inserted into body tissues to be ready for use comprises: a cavity-retaining means which retains a cavity for operation works in the body; and a soft cylinder member which communicates with the cavity retained by the cavity-retaining means and interconnects the space outside with the cavity, and is used for surgery, by allowing an endoscope and operation tools to be inserted through the soft cylinder member into the cavity retained by the cavity-retaining means.

Claim 42

A cavity-retaining tool for surgery according to Claim 41 in which the cavity-retaining means is constituted with a cavity-retaining member which comprises an inner wall facing the cavity and an outer wall facing body tissues.

Claim 43

A cavity-retaining tool for surgery according to Claim 42 in which the cavity-retaining means is a ring member.

Claim 44

A cavity-retaining tool for surgery according to Claim 42 in which the cavity-retaining means is made of a material which can undergo deformation, and expands the cavity with a cavity expanding means and retains the resulting cavity.

Claim 45

A cavity-retaining tool for surgery according to Claim 41 or 42 which has a positioning means to maintains the cavity-retaining means with respect to a desired position in the body.

Claim 46

A cavity-retaining tool for surgery according to Claim 45 in which the positioning means is a handling member which is connected to the cavity-retaining means and extends towards outside the body, and whose cross-sectional area is smaller than that of the cavity formed by the cavity-retaining means.

Claim 47

A cavity-retaining tool for surgery according to Claim 46 in which the handling member has a channel to communicate with the cavity formed by the cavity-retaining means.

Claim 48

A cavity-retaining tool for surgery according to Claim 45 in which the positioning means is represented by indentations formed upon the external wall surface of the cavity-retaining member.

Claim 49

A cavity-retaining tool for surgery according to Claim 45 in which the positioning means has a retraction which extends from the tip of the cavity-retaining member towards the external wall, and which acts as a hook against body tissues.

Claim 50

A cavity-retaining tool for surgery according to Claim 42 in which the cavity-retaining member has a hole prepared on at least a part of its wall which acts as a guide to introduce an endoscope or a tool into the cavity.

Claim 51

A cavity-retaining tool for surgery according to Claim 41 in which the soft cylinder member is produced after a sheet member made of a resin has been made into a tube-like structure.

Claim 52

A cavity-retaining tool for surgery according to Claim 41 in which the soft cylinder member is so constructed that its internal diameter is narrow at the tip and enlarges towards the base end.

Claim 53

A cavity-retaining tool for surgery according to Claim 41 in which the soft cylinder member has its interior partitioned into a plurality of channels.

Claim 54

A cavity-retaining tool for surgery according to Claim 41 in which the soft cylinder member has a hole prepared at least at one spot on the wall which acts as a guide to introduce an endoscope or a tool into the cavity.

Claim 55

A cavity-retaining tool for surgery according to Claim 41 which has a guide member for tool insertion being connected to the cavity-retaining means and extending through the soft cylinder member towards outside the body, and in which the guide member for tool insertion is provided with a guide surface leading to the cavity formed by the cavity-retaining means.

Claim 56

A cavity-retaining tool for surgery according to Claim 55 in which the guide member for tool insertion acts also as a handling member which extends, after being connected to the cavity-retaining means, towards outside the body.

Claim 57

A cavity-retaining tool for surgery according to Claim 41 in which the cavity-retaining means retains a cavity by pouring a fluid into body tissues.

Claim 58

A cavity-retaining tool for surgery according to Claim 41 which has at least one port which is connected to the cavity-retaining means retaining a cavity in body tissues, and led to the cavity thus retained.

Claim 59

A cavity-retaining tool for surgery according to Claim 58 which is further provided with a interconnecting means which connects the cavity-retaining means with the port.

Claim 60

A cavity-retaining tool for surgery according to Claim 59 comprises: a channel which communicates with the cavity formed by the cavity-retaining means, connects one end of the cavity with the space outside the body, and allows insertion of treatment tools; a cavity-retaining tool for surgery which has the cavity-retaining means or at least part of the wall of the channel made of an elastic material; a port for tool introduction which allows insertion of the treatment tools; and a guide member for tool introduction which has a diameter allowing itself to be inserted into the port for tool introduction, and a needle segment which allows itself to penetrate through a soft member having an elastic property at the tip; and forms an interconnecting means: by penetrating an elastic material having an elastic property with the needle segment to produce a hole; by inserting the port through the hole; and by allowing the port to be connected by elasticity to the elastic material.

Claim 61

A cavity-retaining tool for surgery according to Claim 59 in which: the hole which is prepared on a part of the wall and communicates with the cavity for treatment is at the same time expandable and contractible; and the port which has a larger diameter than does the above-described port, and the port is allowed to penetrate the hole while enlarging it and is connected by elasticity to the hole.

Claim 62

A cavity-retaining tool for surgery according to Claim 41 which is further provided with a bone fitting means which fits the tip of the cavity-retaining means to a bone.

Claim 63

A cavity-retaining tool for surgery according to Claim 41 which is further provided with a body penetrating tool which has a means by which to penetrate into muscles in the direction of their fibers.

Claim 64

A cavity-retaining tool for surgery according to Claim 63 in which the body penetrating tool comprises a combination of a plurality of tubular members with different diameters increasing stepwisely.

Claim 65

A cavity-retaining tool for surgery according to Claim 63 in which the body penetrating tool is a tubular member which allows an endoscope to pass through its interior, is provided with an observation window and has, at its end, at least either one of means for coagulation, incision and stripping.

Claim 66

A cavity-retaining tool for surgery according to Claim 63 which is further provided with a guide member which can be placed around the body penetrating tool, allow a sheath for surgery to be inserted into the cavity and allow the cavity-retaining tool to be guided into body tissues.

Claim 67

A cavity-retaining tool for surgery according to Claim 63 in which the cavity-retaining tool can be placed around the body penetrating tool.

Claim 68

An endoscopic surgery system comprises: a cavity-retaining means to retain a cavity in body tissues; and at least a port to be guided into that cavity, and has an interconnecting means which interconnects the port with the cavity-retaining means such that the internal cavity of the port and the cavity retained by the cavity-retaining means communicate in the body:

Claim 69

An endoscopic surgery system according to Claim 68 in which the cavity-retaining member comprises a cavity-retaining member and at least one cylinder member which communicates, through the cavity-retaining member, with the space outside the body.

Claim 70

An endoscopic surgery system according to Claim 68 or 69 in which the cavity-retaining member or the cylinder member is allowed to have at least a hole which connects the treatment space and the cavity retaining surface, the port is allowed to have a thread on its tip, and the port is connected to the hole by screwing the thread into the hole.

Claim 71

An endoscopic surgery system according to Claim 68 or 69 in which the cavity-retaining member or the cylinder member is allowed to have at least a hole which connects the treatment space and the cavity retaining surface, the port is allowed to have a fitting member extending radially on the tip, and the port is connected to the hole by inserting the fitting member into the hole.

Claim 72

An endoscopic surgery system according to Claim 68 or 69 in which the cavity-retaining member or the cylinder member is allowed to have at least a hole which connects the treatment space and the external wall, and the hole is at the same time expandable and contractible; and the port which has a larger diameter than does the above-described port, and the port is allowed to penetrate the hole while enlarging it and is connected by elasticity to the hole.

Claim 73

An endoscopic surgery system according to Claim 68 or 69 which is further provided with a guide member to guide the port into the cavity.

Claim 74

A surgery system according to Claim 68 comprises: a channel which communicates with the cavity-retaining means forming a cavity for surgery and with the cavity formed by the cavity-retaining means, and connects one end of the cavity with the space outside the body, thereby to allow treatment tools to be inserted into the cavity; a cavity-retaining sheath for surgery which has at least part of the cavity-retaining means or of the channel's wall made of a soft material having an elastic property; a port for tool insertion which allows insertion of the treatment tools; and a guide member for tool insertion which has a diameter to allow itself to be inserted into the port for tool insertion, and has a needle segment at the tip which can penetrate the soft member having an elastic property; and forms an interconnecting means: by penetrating the soft material having an elastic property with the needle segment to produce a hole; by inserting the port through the hole; and by allowing the port to be connected by elasticity to the soft material.

Claim 75

A cavity-retaining member to be inserted into the body to be ready for use comprises: a cavity-retaining means to retain a cavity for surgery in the body; and a guide member for tool insertion which is connected to the cavity-retaining member and extends towards the space outside the body, and is so constructed that the guide member for tool insertion has a guide surface which communicates with the cavity formed by the cavity-retaining means.

Claim 76

An endoscopic surgery system comprises; a cavity-retaining member which is placed at the tip to be inserted into the body and can vary the form in the body; and an cavity-expanding means to expand the cavity retained by the cavity-retaining means.

Claim 77

An endoscopic surgery system according to Claim 76 which is further provided with at least a cylinder member which communicates with the cavity-retaining member and with the space outside the body.

Claim 78

An endoscopic surgery system according to Claim 77 in which the cavity retaining means is made of a material which can undergo plastic deformation and which has a rejecting surface and a surface facing the cavity.

Claim 79

An endoscopic surgery system according to Claim 77 in which: the cavity-retaining member is made of an elastic member and has a rejecting surface and cavity facing surface which are so curved as to be wider than the cylinder member; the cavity expanding means is so constructed as to slide freely through the outer pipe covering the elastic member, and the outer pipe is so constructed as to slide freely at least from the tip of the elastic member to the cylinder member; and the elastic member widens its tip when the outer pipe slides up to the cylinder member.

Claim 80

An endoscopic surgery system according to Claim 78 in which the cavity-retaining means in the form of a circle or an ellipsoid has a structure (mesh structure) at least part of which comprises a plurality of windows.

Claim 81

An endoscopic surgery system according to Claim 78 in which the cavity-retaining means is constituted with a plurality of strip members.

Claim 82

An endoscopic surgery system according to Claim 78 in which the cavity-retaining means in the form of a circle or an ellipsoid is made of strip members, and has part of it folded.

Claim 83

An endoscopic surgery system according to Claim 79 in which the cavity-retaining means comprises a plurality of strips made of an elastic material.

Claim 84

An endoscopic surgery system according to Claim 77 in which the cavity-retaining means is constituted with cords knitted into a texture.

Claim 85

An endoscopic surgery system according to Claim 78 which allows the cavity enlarging means comprising a shaft, a balloon, and a means to guide a gas into the balloon, to be introduced into the interior of the cavity-retaining tool.

Claim 86

An endoscopic surgery system according to Claim 77 which is provided with a cavity-expanding means which has at least a pressing surface on its tip; and allows the cavity expanding tool comprising a means to expand the pressing surface, to be introduced into the interior of the cavity-retaining tool.

Claim 87

A cavity-retaining tool for bone surgery to be introduced into the body, and to treat a bone in a cavity with the tip of a cavity-retaining tool, which has an observation means by which to observe the cavity endoscopically and a treatment channel which allows the passage of treatment tools; and the treatment involving the use of that cavity-retaining tool for bone surgery with a fitting means at the tip by which to fix the tool to a bone comprises in order: a step of inserting the cavity-retaining tool through a skin incision into the body; a step of fitting the cavity-retaining tool to a bone; a step of observing with an endoscope or the observation means the cavity; and a step of inserting treatment tools through the treatment channel, and of treating the bone under endoscopic observation.

Claim 88

A treatment method according to Claim 87 which is further provided with a step of exposing the frontal aspect of a vertebral body in an pneumoperitoneum under laparoscopic observation and of fitting the sheath to the vertebral body.

Claim 89

A treatment method according to Claim 87 which is still further provided with a step of advancing into muscles, reaching the posterior aspect of a vertebral body, and fitting the sheath to the vertebral body.

Claim 90

A sheath for cavity retention which is inserted into body tissues, and forms a cavity in the body to act as a space for the treatment of a vertebral body which is utilized as an element of an implant guide sheath which comprises: a treatment channel to guide treatment tools to treat a vertebral body and an implant to the space for the treatment of a vertebral body; an observation means by which to observe endoscopically the operation field within the space for the treatment of a vertebral body; and a fitting means by which to fit the sheath to the vertebral body, and its use comprises in order: a step of inserting the implant guide sheath through a skin incision into a body cavity; a step of fitting the implant guide sheath to a vertebral body; a step of observing endoscopically the space for the treatment of the vertebral body; a step of inserting treatment tools through the treatment channel, and of treating the vertebral body under endoscopic observation. and a step of placing, through the treatment channel, the implant into the intervertebral space.

Claim 91

A sheath for cavity retention which is inserted into body tissues, and forms a cavity in the body to act as a space for the treatment of a vertebral body which is utilized as an element of an implant guide sheath which comprises: a treatment channel to guide treatment tools to treat a vertebral body and an implant to the space for the treatment of a vertebral body; an observation means by which to observe endoscopically the operation field within the space for the treatment of a vertebral body; and a fitting means by which to fit the sheath to the vertebral body, and its use comprises in order: a step of inserting the implant guide sheath through a skin incision into a body cavity; a step of fitting the implant guide sheath to a site into which a first implant is to be buried; a step of, while observing endoscopically the space for the treatment of the vertebral body; inserting treatment tools into the treatment channel to treat the vertebral body; a step of, after having released the fixation of the implant guide sheath from the site for the first implant, fitting the implant guide sheath to the site into which a second implant is to be buried; a step of, while observing endoscopically the space for the treatment of the vertebral body; inserting treatment tools into the treatment channel to treat the vertebral body; a step of, while observing endoscopically the space for the treatment of the vertebral body; inserting the first implant and burying it in the intervertebral space; a step of, after having released the fixation of the implant guide sheath from the site for the second implant, fixing the implant guide sheath to the site into which the first implant has been buried; a step of, while observing endoscopically the space for the treatment of the vertebral body; inserting the treatment tools into the treatment channel to treat the vertebral body; and a step of, while observing endoscopically the space for the treatment of the vertebral body; inserting the second implant and burying it in the intervertebral space.