CN112244950B - Interventional instrument - Google Patents

Interventional instrument Download PDF

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Publication number
CN112244950B
CN112244950B CN202010947369.9A CN202010947369A CN112244950B CN 112244950 B CN112244950 B CN 112244950B CN 202010947369 A CN202010947369 A CN 202010947369A CN 112244950 B CN112244950 B CN 112244950B
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China
Prior art keywords
handle
sheath
tube
driving
adsorption
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CN202010947369.9A
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CN112244950A (en
Inventor
王云兵
吴智明
叶正宇
余越盛
邵南
訾振军
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Deke Medtech (hangzhou) Inc
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Deke Medtech (hangzhou) Inc
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Priority to CN202010947369.9A priority Critical patent/CN112244950B/en
Publication of CN112244950A publication Critical patent/CN112244950A/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421Cannulas
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3478Endoscopic needles, e.g. for infusion
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B2017/3454Details of tips

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Pathology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

The application discloses an interventional instrument, which comprises a sheath tube, a handle connected to the near end of the sheath tube and an adsorption head connected to the far end of the sheath tube; the adsorption head is provided with a working cavity, an adsorption port which is communicated with the working cavity and is used for acting with an adsorbed object, and an adsorption channel and an operation channel which are respectively communicated with the working cavity; slidable mounting has the interior needle tubing that can stretch out or withdraw the absorption mouth via operation passageway in the sheath pipe, be equipped with many haulage wires in the sheath pipe, each haulage wire one end is fixed to the distal end position of sheath pipe, the other end of each haulage wire extends to the handle, each haulage wire can be driven to the handle, wherein at least one haulage wire pulls the absorption head under the drive of handle and moves towards one side at absorption mouth place, this scheme is for prior art, the vacuum adsorption power that produces by the absorption passageway directly transmits to operation passageway, can keep puncture point peripheral tissue position when puncturing, skew or drop for the absorption head, ensure the accuracy of puncture position.

Description

Interventional instrument
Technical Field
The application relates to the field of medical equipment, in particular to an interventional instrument.
Background
In many surgeries requiring precise manipulation, how to keep medical instruments in a stable state with respect to a living body has been a medical problem. For example, in cardiac surgery, the difficulty of the operation is greatly increased because the heart cannot be suspended during the operation and the operation is always performed on the moving heart.
In practice, this presents a difficult problem for the physician to perform cardiac puncture and post-puncture infusion of compounds, since the heart is in a beating state. Because the heart is in a beating state, the puncture needle is easy to slip when puncturing due to the fluctuation of the heart, and further deviates from a target point, so that the difficulty of more stably operating the heart by operation instruments such as the puncture needle, an endoscope and the like is solved.
Despite the prior art disclosures of solutions, such as remote use of suction devices and the like, there is still a need for improved positioning.
Disclosure of Invention
In order to solve the above technical problem, the present application provides an interventional device, including a sheath, a handle connected to a proximal end of the sheath, and an absorption head connected to a distal end of the sheath;
the adsorption head is provided with a working cavity, an adsorption port which is communicated with the working cavity and is used for acting with an adsorbed object, and an adsorption channel and an operation channel which are respectively communicated with the working cavity; sliding mounting has the via in the sheath pipe operating channel stretches out or retracts the interior needle tubing of absorption mouth, be equipped with many haulage wires in the sheath pipe, each haulage wire one end is fixed extremely the distal end position of sheath pipe, the other end of each haulage wire extends to the handle, each haulage wire can be driven to the handle, wherein at least one haulage wire is in pull under the drive of handle the absorption head court the one side motion at absorption mouth place.
The adsorption channel and the operation channel are communicated with each other in the adsorption head through the working cavity, the vacuum adsorption force generated by the adsorption channel is directly transmitted to the operation channel, the tissue position around the puncture point can be kept when puncture is carried out, and the puncture position is deviated or falls off relative to the adsorption head, so that the accuracy of the puncture position is ensured.
The distal end of sheath pipe is transferred through each traction wire and is bent, and each traction wire is different to the direction of transferring of sheath pipe to make the distal end bending range of sheath pipe wider, adsorb the head and rely on one of them traction wire to accomplish the action of transferring the turn to adsorbing a mouthful one side, make things convenient for the adsorption head to adsorb at tissue organ, and puncture through interior needle tubing.
Several alternatives are provided below, but not as an additional limitation to the above general solution, but merely as a further addition or preference, each alternative being combinable individually for the above general solution or among several alternatives without technical or logical contradictions.
Optionally, the arrangement of the working chamber is as follows:
a body cavity, or
Include a plurality of sub-chambeies at the inside mutual intercommunication of adsorption head, adsorb passageway and operation passageway respectively with the sub-chamber intercommunication that corresponds, the absorption mouth communicates at least the sub-chamber at operation passageway place.
The working cavity is a body cavity, namely enough space is provided for arranging the auxiliary components, and the blockage problem caused by the narrow communication part can be avoided.
The working chamber is a plurality of sub-chambers, and a plurality of sub-chambers are inside to communicate with each other for all sub-chambers in the working chamber all can reach vacuum state through suction device with the adsorption channel intercommunication, rely on inside and outside pressure difference to form the adsorption affinity and adsorb in the adsorbate, avoid moving because of the top of pjncture needle and lead to the adsorption head to break away from the adsorbate.
Optionally, the working chamber is a body cavity, the operation channel with the communication position of working chamber is first intercommunication mouth, adsorb the passageway with the communication position of working chamber is second intercommunication mouth, first intercommunication mouth and second intercommunication mouth all are in the near-end side of working intracavity wall, the second intercommunication mouth for first intercommunication mouth is closer to adsorb the mouth.
The first communication port is a channel port of the puncture needle entering the working cavity, the puncture needle needs to bend and tilt towards the adsorption port after entering the working cavity, and in order to ensure a better puncture angle, enough bending and tilting space needs to be reserved, so that the position of the first communication port is far away from one side of the adsorption port as far as possible.
Optionally, an endoscope channel and a cleaning channel which are respectively communicated with the working cavity are further arranged on the proximal end side of the adsorption head;
in the adsorption channel, the operation channel, the endoscope channel and the cleaning channel, the channels are mutually independent or at least the two channels are closed and communicated, and the channels are respectively formed in the following modes:
a channel is formed by opening a hole on the adsorption head, the far end of the hole is communicated with the working cavity, and the near end of the hole is opened to be in butt joint with an external pipeline;
or a pipeline is arranged in the opening in a penetrating way, the far end of the pipeline is communicated with the working cavity, and the near end of the pipeline extends out of the adsorption head.
The endoscope channel is provided with the endoscope for observing the condition in the working cavity, the endoscope channel is divided into a front section and a rear section, the rear section is arranged along the axial extension of the adsorption head, the front section inclines or bends towards one side of the adsorption port and is communicated with the working cavity, and the lens of the endoscope can be aligned to the adsorption port after being arranged along the endoscope channel, so that the target spot can be conveniently found and the condition in the working cavity can be observed.
The cleaning channel is used for conveying cleaning liquid for cleaning the working cavity and the endoscope and keeping the working cavity and the endoscope clean. In the operation process, blood or other impurities pollute the lens of the endoscope and cannot observe the condition in the working cavity, so as to effectively keep the lens of the endoscope clean.
Optionally, a sealing lip for abutting against an adsorbate is convexly arranged on the periphery of the adsorption port.
The seal lip is mainly used for better isolating the outside air and the liquid from entering the working cavity when the adsorption port is attached to the surface of the adsorbate, and preventing the adsorption head from being separated from the adsorbate after the outside air enters.
Optionally, the sealing lip is annular and has a flange.
This further increases the contact area with the adsorbate.
Optionally, the opening part of the adsorption port is a communication area or is divided into a plurality of unit areas; the plurality of unit regions are formed in a regularly distributed grid structure or a random porous structure.
The adsorption port of each unit area can generate adsorption force, and the phenomenon that the adsorption head falls off due to the fact that the puncture is pushed is avoided, and operation is affected. The height of the adsorbate protrusion extending into the adsorption port is reduced, the surface of the adsorbate is protected from being scratched, and meanwhile, the control of the puncture depth is more accurate.
Optionally, a rotating member is installed in the handle, wherein the bending directions of the two pulling wires are opposite, and the two pulling wires are connected to the rotating member in opposite winding directions.
The rotating part drives the two traction wires to synchronously and reversely move when rotating, so that the two traction wires are prevented from reversely stretching when the sheath tube is bent, the sheath tube is prevented from bending resistance and potential safety hazards exist, and more bending adjusting angles are provided for bending adjustment of the sheath tube.
Optionally, the rotating part is disc-shaped, and the rotation axis is perpendicular to the plane of the adsorption port.
Optionally, a first bending adjusting chamber and a second bending adjusting chamber are arranged in the handle, and the pull wire comprises a first pull wire, a second pull wire and a third pull wire;
and a driving disc is rotatably arranged in the first bending adjusting chamber, the near ends of the first traction wire and the second traction wire are connected with the driving disc, and the driving disc drives the first traction wire and the second traction wire to synchronously and reversely move when rotating.
The distal end of the sheath tube is bent through the first traction wire, the second traction wire and the third traction wire, the bending directions of the traction wires to the sheath tube are different, so that the bending range of the distal end of the sheath tube is wider, and the first traction wire and the second traction wire are locked through the locking mechanism when adjusted to preset positions; meanwhile, each traction wire can respectively bend the distal end of the sheath tube, so that an operator can more flexibly adjust the bending direction of the sheath tube.
Optionally, at least a part of the first traction wire and the second traction wire is wound around the periphery of the driving disc, or wound in a wire groove on the axial disc surface of the driving disc.
Optionally, the first traction wire and the second traction wire are arranged oppositely along the radial direction of the sheath, the third traction wire is located between the first traction wire and the second traction wire in the circumferential direction of the sheath, and the orientation of the adsorption port is consistent with the circumferential position of the third traction wire relative to the sheath.
The third traction wire pulls the adsorption head court during the one side motion at absorption mouth place, the adsorption head of being convenient for adsorbs at the tissue organ, and the accent of third traction wire is bent the direction and is perpendicular setting with the accent of first traction wire and second traction wire, and the accent of sheath pipe distal end combination each traction wire is bent the direction to the distal end bending range that makes the sheath pipe is wider.
Optionally, the handle is provided with an operation slot communicated with the first bending adjusting chamber; the periphery of the driving disc is provided with a driving handle, and the driving handle extends out of the first bending adjusting chamber from the operating slot.
The operator holds the part of the driving handle positioned outside the first bending chamber, and then stirs the driving disc to rotate through the driving handle, so that the operator can conveniently control the driving disc to rotate.
Optionally, the handle includes the supporter and rotates the rotatory handle of installing in the supporter periphery the supporter with enclose into the second between the rotatory handle and transfer the curved room, slidable mounting has the linkage on the supporter, the near-end of third traction wire with the linkage links to each other and is used for pulling the adsorption head court the one side motion at absorption mouth place.
The operator is through rotating rotatory handle, and rotatory handle drives the linkage and slides on the supporter to it is crooked to drive the distal end that the traction wire pull the sheath pipe, and it is crooked towards fixed direction to drive the adsorption head at last, so that the adsorption head avoids the tissue organ, reduces the damage to the tissue organ.
Optionally, the outer periphery of the linkage member is provided with an external thread, and the inner wall of the rotary handle is provided with an internal thread matched with the external thread.
The rotation of the rotary handle can be converted into the sliding of the linkage piece on the supporting body by the threaded connection mode of the rotary handle and the linkage piece, so that the movement of the linkage piece is more stable. Meanwhile, the linkage piece can realize the self-locking phenomenon, and the reset force of the sheath tube is prevented from driving the linkage piece to move.
Optionally, the handle further comprises a locking mechanism for locking or releasing the driving disc, and the locking mechanism continuously defines the rotation angle of the driving disc or gradually defines the rotation angle of the driving disc.
The operator drives corresponding traction wire when controlling the driving-disc, driving-disc rotation, and the distal end position of traction wire drive sheath pipe is crooked, when the distal end position of sheath pipe is crooked to preset position, through locking mechanical system with the driving-disc locking to avoid outside effort mistake to touch the driving-disc, cause the driving-disc to rotate, can influence the distal end of sheath pipe and transfer the angle of bending.
Optionally, the locking mechanism comprises:
and the knob is in threaded fit with the handle, at least one part of the knob is exposed outside the handle, and in the rotating process of the knob, the knob is far away from or presses against the driving disc, and the driving disc is locked in a pressed state.
When the distal end position of sheath pipe is crooked to preset position, through the knob butt with the driving-disc locking to avoid outside effort mistake to touch the driving-disc, cause the driving-disc to rotate, can influence the distal end accent angle of sheath pipe.
Optionally, the locking mechanism comprises:
a plurality of locking grooves arranged on the driving disc along the circumferential direction of the driving disc;
the positioning piece is movably installed in the first bending adjusting chamber, and in the rotating process of the driving disc, the positioning piece is clamped with the corresponding locking groove.
When the distal end position of sheath pipe is crooked to preset position, the setting element carries out the block with corresponding locking groove to with the driving-disc locking, touch the driving-disc with avoiding outside effort mistake, cause the driving-disc to rotate, can influence the distal end bending angle of sheath pipe.
Optionally, the elastic driving element is abutted against the positioning element to drive the positioning element to be clamped with the corresponding locking groove.
When the distal end part of the sheath tube is bent to a preset position, the positioning piece is clamped with the corresponding locking groove under the action of the elastic driving piece.
Optionally, the interventional instrument further comprises an outer needle tube located in the sheath, a distal end of the outer needle tube is fixedly butted with or fixedly extended in the operation channel, and a proximal end of the outer needle tube is extended and fixed to the handle;
the handle is movably provided with a driving piece, the inner needle tube is arranged in the outer needle tube in a penetrating mode in a sliding mode, the near end of the inner needle tube extends out of the outer needle tube and is linked with the driving piece, and the inner needle tube and the outer needle tube are arranged in a sealing mode in the radial gap.
The gap between the outer needle tube and the inner needle tube is blocked, and the medium is prevented from permeating.
Optionally, the handle is further provided with an installation chamber at a proximal end of the second bending adjustment chamber, a threading sleeve is fixed in the installation chamber, a proximal end of the outer needle tube extends into the threading sleeve and is in fixed sealing fit with an inner wall of the threading sleeve, a proximal end of the inner needle tube sequentially extends out of the outer needle tube and the threading sleeve and then is connected to the driving member, and the inner needle tube is in sliding sealing fit with the inner wall of the threading sleeve.
The threading sleeve with the sealing structure is arranged between the outer needle tube and the inner needle tube, so that the blood is prevented from flowing backwards into the handle, the use of internal parts is prevented from being influenced, and the puncture operation is not influenced.
Optionally, the inner needle tube comprises a first delivery tube and a second delivery tube nested inside and outside, wherein:
the first conveying pipe is positioned at the inner side, the far end of the first conveying pipe is of a spine structure, and a perfusion opening is formed in the pipe wall of the first conveying pipe, which is adjacent to the far end;
the second delivery pipe is positioned at the outer side, and the distal end of the second delivery pipe hermetically surrounds the perfusion opening;
the inside of the first conveying pipe is used as a first injection channel, the radial gap between the second conveying pipe and the first conveying pipe is used as a second injection channel, and the second injection channel is communicated with the first injection channel through the perfusion opening.
In this embodiment, through the mode of inside and outside nested with first conveyer pipe and second conveyer pipe integration, avoid the parallel arrangement of many pipelines, different injection purposes can be realized to same puncture action, and on this basis, corresponding improvement has also been made to the mode of setting up and the concrete position of pouring into mouthful, can reduce the operation residue of last time
Optionally, interior needle tubing penetrates in the handle and wears out from the handle near-end by the handle distal end, the near-end butt joint of interior needle tubing has the tee bend that is in the handle outside, first conveyer pipe with the second conveyer pipe passes through the tee bend divides into two independent ways separately.
The first delivery pipe and the second delivery pipe are branched after extending out of the proximal end of the handle, and are connected with respective auxiliary equipment, and the three-way structure can be pre-formed, so that the assembly is convenient, and the pipeline butt joint is relatively simplified.
This application intervenes apparatus and improves positioning effect through the improvement of absorption mode, and further still combine the improvement of adjusting curved, the positioning process's that adjusts curved, efficiency.
Drawings
FIG. 1 is a schematic structural view of an interventional instrument according to an embodiment provided herein;
FIG. 2 is a partial schematic structural view of the interventional instrument of FIG. 1;
FIG. 3 is an exploded view of the handle structure of FIG. 2;
FIG. 4 is a schematic view of the structure of FIG. 2 with the rotating handle partially omitted;
FIG. 5 is a schematic view of the mounting ring installed within the sheath;
FIG. 5a is a schematic view of the liner, retaining ring and sheath arrangement of the present application;
FIG. 5b is a schematic view of the mounting ring installed within the sheath;
FIG. 6 is a schematic view of the mounting ring installed within the sheath;
FIG. 7 is an enlarged view of the portion B of FIG. 6;
FIG. 8 is a schematic view of the movement of the distal end of the sheath tube of FIG. 1;
FIG. 9 is a schematic view of the movement of the distal end of the sheath tube of FIG. 1;
FIG. 10 is a schematic structural view of the drive plate of FIG. 3;
FIG. 11 is a schematic structural view of the drive plate of FIG. 3;
FIG. 12 is a schematic view of the structure of the drive plate and the traction wire;
FIG. 13 is an enlarged view of the portion A of FIG. 4;
FIG. 14 is a schematic view of the handle of FIG. 2 with a portion of the handle omitted;
FIG. 15 is an enlarged view of the portion C of FIG. 14;
FIG. 16 is a schematic structural view of the support body of FIG. 14;
FIG. 17 is an exploded view of the handle structure according to the first embodiment;
FIG. 18 is a schematic structural view of the second housing shown in FIG. 17 according to an embodiment;
FIG. 19 is a schematic structural diagram of the drive disc of FIG. 17 in accordance with one embodiment;
FIG. 20 is a schematic view of the knob of FIG. 17 according to an embodiment;
FIG. 21 is an exploded view showing the structure of the handle according to the second embodiment;
FIG. 22 is a schematic structural view of the second embodiment of the drive disk of FIG. 21;
FIG. 23 is a schematic view illustrating the assembly of the positioning member according to the second embodiment;
fig. 24 is a schematic view of the puncture needle of the present application in a puncture configuration;
FIG. 25 is a schematic view of the structure of the puncture needle of the present application when it is withdrawn;
fig. 26 is a perspective view of an adsorption head of the present application;
FIG. 27 is another perspective view of the suction head of the present application;
fig. 28 is a perspective view of the structure of the suction head of the present application in use;
FIG. 29 is a radial cross-sectional view of a working chamber of an adsorption head of the present application;
FIG. 29a is an enlarged view of the portion D in FIG. 29;
FIG. 30 is a rear view of the suction head of the present application;
FIG. 31 is an axial cross-sectional view of the suction head of the present application;
FIG. 32 is a schematic view of a piercing process of the suction head of the present application;
FIG. 33 is a schematic view of a piercing process of an adsorption head according to another embodiment of the present application;
FIG. 34 is an enlarged, fragmentary view of the handle of FIG. 1;
FIG. 35 is an enlarged schematic view of the handle of FIG. 1 with a portion removed;
FIG. 36 is an exploded view of the handle of FIG. 1;
FIG. 37 is an enlarged schematic view of another embodiment of the handle portion of FIG. 1;
FIG. 38 is a schematic structural view of a positioning member of the present application;
FIG. 39 is a schematic view of the arrangement of the scale markings of the present application;
FIG. 40 is a schematic view of the structure of the observation window of the present application;
FIG. 41 is a schematic structural view of the driving member of the present application;
FIG. 42 is a schematic view of the positioning member of the present application abutting the indicator;
FIG. 43 is a schematic view of the inner needle cannula of the present application;
FIG. 44 is a schematic view of another embodiment of an inner needle cannula of the present application;
FIG. 45 is a schematic view of the internal structure of the handle of the interventional instrument of the present application;
FIG. 46 is an enlarged view of portion D of FIG. 45;
FIG. 47 is an enlarged view of section E of FIG. 46;
FIG. 48 is a perspective view of a pull-through sleeve construction of the present application;
FIG. 49 is a cross-sectional view of a lead-through sheath construction of the present application;
FIG. 50 is a cross-sectional structural view of another embodiment of the passing sleeve of the present application;
FIG. 51 is a schematic view of a second retaining groove according to the present application;
FIG. 52 is a schematic view of the inner needle cannula of the injection device of the present application;
FIG. 53 is a schematic view of a tee in an injection device of the present application;
FIG. 54 is a schematic view of the connection of the inner needle cannula and the tee in the injection device of the present application;
FIG. 55 is a schematic view of the connection of the inner needle cannula, the tee and the transition tube of the injection device of the present application;
FIG. 56 is a schematic view of the configuration of a transition tube in an injection device of the present application;
FIG. 57 is a schematic view of a three-way junction and a transfer tube in an injection device of the present application;
FIG. 58 is a perspective view of a tee in the injection device of the present application;
FIG. 59 is a schematic perspective view of a three-way junction with a transfer tube of the injection device of the present application;
FIG. 60 is a schematic view of another embodiment of an inner needle cannula of an injection device of the present application.
The reference numerals in the figures are illustrated as follows:
100. an interventional instrument; 101. an endoscope; 102. cleaning the tube; 105. a locking mechanism;
10. a handle; 11. a support body; 111. a guide groove; 112. a through hole; 113. a guide plate; 114. a support shoulder; 115. a limiting shoulder; 12. rotating the handle; 13. a second bend adjusting chamber; 14. a linkage member; 142. threading holes; 15. drawing wires; 151. a first pull wire; 152. a second pull wire; 153. a third traction wire; 16. a mounting ring; 161. a rotating groove; 18. a first housing; 181. a second housing; 182. a first bend adjusting chamber; 183. an operation slot; 184. a rotation stopping groove; 185. an observation window; 19. a rotating member;
20. a sheath tube; 21. a first section of sheath; 22. a second section of sheath tube; 23. a third section of sheath tube; 24. a fixing ring; 241. positioning a groove; 25. an isolation sleeve; 26. a liner tube;
30. an adsorption head; 31. a working chamber; 32. a vacuum tube; 321. an adsorption channel; 33. an operation channel; 34. an endoscope channel; 35. cleaning the channel; 36. a guide section; 361. a guide groove; 362. a curved groove; 37. a first communication port; 371. a second communication port; 372. a third communication port; 373. a fourth communication port; 38. an adsorption port;
40. puncturing needle; 41. a guide tube; 42. a needle head; 43. an inner needle tube; 44. an outer needle tube; 45. a sliding section; 46. a curved section; 410. a first delivery pipe; 420. a second delivery pipe; 430. a needle tip; 440. a needle opening; 450. a first conveyance path; 460. a second conveyance path;
50. a drive disc; 51. a drive handle; 52. a wire slot; 521. an arc-shaped section; 522. a turning section; 523. a wire inlet; 53. a positioning area; 54. a mounting member; 55. a locking groove; 56. a rotating shaft; 57. a groove;
60. a first locking mechanism; 61. a knob; 611. a housing; 612. an action part; 613. a convex strip; 62. an elastic pad; 621. a rotation stop section; 63. a spacer; 631. an end plate; 64. connecting sleeves; 641. a drive slot;
70. a second locking mechanism; 71. a positioning member; 72. an elastic driving member; 73. mounting a column; 731. an anti-drop step;
500. a transfer tube; 510. a boss; 520. a through hole; 530. an annular step;
600. a joint; 610. a connecting pipe;
800. a tee joint; 810. a first joint; 820. a second joint; 830. a third joint; 840. an opening portion; 850. an open end face; 860. an adaptation structure;
901. a first handle shell; 902. a second handle shell;
910. a drive member; 911. a first operation section; 912. an extension portion; 913. an indicator;
920. threading a sleeve; 930. a seal member; 940. a positioning member; 941. a second operation section; 942. a fastening part; 943. a blocking portion; 944. the head is prevented from falling off; 950. a card slot; 960. scale marks; 970. a guide groove; 980. a hollow-out area; 990. an observation window;
9001. a first guide groove; 9002. a second limit groove; 9003. an inner edge surface; 9004. a plane; 9005. a first planar zone; 9006. a second planar region; 9103. a boss; 9104. anti-skid lines; 9121. avoiding holes;
9201. a fixing hole; 9202. a guide section; 9203. an installation port; 9204. a limiting groove; 9301. avoiding holes; 9411. an annular portion.
Detailed Description
The technical solutions in the embodiments of the present application will be clearly and completely described below with reference to the drawings in the embodiments of the present application, and it is obvious that the described embodiments are only a part of the embodiments of the present application, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present application.
It will be understood that when an element is referred to as being "connected" to another element, it can be directly connected to the other element or intervening elements may also be present. When a component is referred to as being "disposed on" another component, it can be directly on the other component or intervening components may also be present.
Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this application belongs. The terminology used in the description of the present application herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the application. As used herein, the term "and/or" includes any and all combinations of one or more of the associated listed items.
As shown in fig. 1, the present application provides a handle 10 for use with an interventional device 100, the interventional device 100 being used for medical puncturing or injection of drugs, biological materials or aspiration of bodily fluids, the interventional device 100 comprising a sheath 20, the handle 10, the sheath 20 having opposite distal (the end proximal to the patient) and proximal (the end proximal to the operator).
The interventional device 100 of the present application is used to puncture the heart (not shown) and inject a non-contractile substance (not shown) such as a self-coagulating, biocompatible hydrogel into the ventricular wall of the heart.
The interventional device 100 sends the distal end of the sheath 20 into the human body and moves to the vicinity of the tissue organ, and controls the components at the distal end of the sheath 20 (such as the suction head 30, the puncture needle 40 and the endoscope 101) through the handle 10 to complete a series of treatment operations including target point searching, suction, puncture injection and the like.
The inventors found that when the puncture operation is performed on a beating heart, the suction head 30 is detached from the adsorbate by the pushing movement of the puncture, and it is difficult to continuously and effectively suck the adsorbate to the heart. If the adsorption force is increased, the surface of the heart is easily damaged, the volume of the adsorption head 30 is increased, and the adsorption area is increased, but the movement in a narrow inner space is influenced.
In one embodiment, as shown in fig. 1, 24-33, an interventional instrument 100 includes a sheath 20, a handle 10 coupled to a proximal end of the sheath 20, and a suction head 30 coupled to a distal end of the sheath 20;
the adsorption head 30 is provided with a working cavity 31, an adsorption port 38 communicated with the working cavity 31 and used for interacting with an adsorbed object, and an adsorption channel 321 and an operation channel 33 respectively communicated with the working cavity 31;
an inner needle tube 43 capable of extending out of or retracting into the adsorption port 38 through the operation channel 33 is slidably mounted in the sheath tube 20, a plurality of traction wires 15 are arranged in the sheath tube 20, one end of each traction wire 15 is fixed to the distal end portion of the sheath tube 20, the other end of each traction wire 15 extends to the handle 10, the handle 10 can drive each traction wire 15, and at least one traction wire 15 pulls the adsorption head 30 to move towards the side where the adsorption port 38 is located under the driving of the handle 10.
The suction channel 321 and the operation channel 33 are communicated with each other inside the suction head 30 through the working cavity 31, and the vacuum suction force generated by the suction channel 321 is directly transmitted to the operation channel 33, so that the tissue position around the puncture point can be maintained during puncture, the shift or falling off of the tissue position relative to the suction head 30 is avoided, and the accuracy of the puncture position is ensured.
If the vacuum adsorption part is positioned in two mutually isolated areas relative to the puncture point, the adsorption effect is difficult to ensure, the deformation of tissues around the puncture point can influence the prejudgment of the puncture depth, the due treatment effect cannot be achieved, and even the operation failure is caused.
The working chamber 31 is an operation space for the internal device of the suction head 30, and is disposed at the distal end of the suction head 30 to provide a sufficient installation space for the arrangement of other components.
The distal end of the sheath tube 20 is bent through the traction wires 15, the bending directions of the sheath tube 20 by the traction wires 15 are different, so that the bending range of the distal end of the sheath tube 20 is wider, the adsorption head 30 finishes the bending action towards one side of the adsorption port 38 by means of one traction wire 15, the adsorption head 30 is conveniently adsorbed on a tissue organ, and puncture is carried out through the puncture needle 40.
As shown in fig. 2 to 4, the handle 10 has a first bending adjusting chamber 182 and a second bending adjusting chamber 13 therein, the driving disk 50 is rotatably mounted in the first bending adjusting chamber 182, and the link 14 is slidably mounted in the second bending adjusting chamber 13;
the pull wires 15 comprise a first pull wire 151, a second pull wire 152 and a third pull wire 153, proximal ends of the first pull wire 151 and the second pull wire 152 are connected with the driving disc 50, and proximal ends of the third pull wire 153 are connected with the linkage member 14;
the driving disc 50 drives the first traction wire 151 and the second traction wire 152 to move in a synchronous and reverse direction when rotating, so that the situation that the first traction wire 151 and the second traction wire 152 are reversely stretched when bending the sheath tube 20 to cause bending resistance of the sheath tube 20 and potential safety hazards exists is avoided, and more bending adjusting angles are provided for bending adjustment of the sheath tube 20.
In the present application, the distal end of the sheath 20 is bent by the first traction wire 151, the second traction wire 152 and the third traction wire 153, and the bending directions of the sheath 20 by the traction wires 15 are different, so that the bending range of the distal end of the sheath 20 is wider; meanwhile, each traction wire 15 can respectively bend the distal end of the sheath tube 20, so that an operator can more flexibly adjust the bending direction of the sheath tube 20.
The distal end of the sheath tube 20 bends and simultaneously drives the adsorption head 30 to bend towards a fixed direction, so that the adsorption head 30 avoids the tissue and the organ, and the damage to the tissue and the organ is reduced.
After the operator releases the handle 10, the first pulling wire 151, the second pulling wire 152 and the third pulling wire 153 release the restriction on the sheath tube 20, and the sheath tube 20 is automatically reset or reset by the inner shaping piece arranged on the sheath tube 20.
When the driving disk 50 on the handle 10 rotates to drive the first traction wire 151 and the second traction wire 152, the distal end of the sheath tube 20 driven by the first traction wire 151 and the second traction wire 152 is bent, when the distal end of the sheath tube 20 is bent to a predetermined position, the driving disk 50 is locked by the locking mechanism 105, so as to avoid the external acting force from touching the driving disk 50 by mistake, and the driving disk 50 rotates, and the bending angle of the distal end of the sheath tube 20 can be influenced.
The driving disk 50 is rotatably installed in the first bending chamber 182 by a rotating shaft, and the axis of the rotating shaft is perpendicular or oblique to the axis of the sheath tube 20. Preferably, the rotational axis of the driving disk 50 is disposed perpendicular to the axis of the sheath 20.
In one embodiment, as shown in fig. 1, a puncture needle 40 is further inserted into the sheath 20, the puncture needle 40 can slide in the sheath 20, and the distal end of the puncture needle 40 can bend along with the bending of the sheath 20. The puncture needle 40 is provided with a puncture end (one end close to a patient) and a connecting end (one end close to an operator) which are arranged in a back direction, the connecting end of the puncture needle 40 is arranged in the handle 10, the puncture end of the puncture needle 40 extends out of the sheath tube 20 for puncture, and the puncture section of the puncture needle 40 punctures to a preset target point and performs injection or suction, thereby providing a foundation for subsequent treatment.
In one embodiment, as shown in fig. 1, the interventional device 100 further includes an absorption head 30 located at the distal end of the sheath 20, the interventional device 100 sends the absorption head 30 and the sheath 20 into the human body and moves to the vicinity of the tissue organ, and the handle 10 controls the movement of the absorption head 30 and the operation of internal devices of the absorption head 30 (such as a puncture needle 40 and an endoscope), so as to complete a series of treatment operations including target point finding, absorption, puncture injection, and the like. The external portion of the interventional instrument 100 may also be provided with auxiliary equipment (e.g., suction devices and cleaning devices) that are connected to the interior of the suction head 30 via tubing or passages and that assist in the operation of the internal devices.
As shown in fig. 1, the sheath 20 is substantially cylindrical. Of course, in other embodiments, the sheath 20 may have other shapes, such as an elliptical shape. The sheath 20 may be formed by combining a plurality of segments in order to obtain corresponding rigidity at different positions, and each segment may have a single-layer structure or a multi-layer composite structure.
In one embodiment, the sheath 20 includes a first segment 21, a second segment 22 and a third segment 23 from the distal end to the proximal end. The first section of sheath 21 is connected with the adsorption head 30, the hardness of the material is the softest in the three sections of sheaths 20, for example, Pebax 3533 is adopted, the sheath 20 is bent through the first section of sheath 21, and meanwhile, the bending radius of the first section of sheath 21 is adjustable, even if the puncture path of the sheath 20 is adjustable, the operation shape of the sheath 20 is stronger, the capability of the sheath 20 for bypassing blood vessels, bones and nerve tissues is stronger, the risk of organs is reduced, and the organs are punctured to a target point more accurately.
The hardness of the material of the third sheath 23 is the hardest among the three sheaths 20, and the hardness can be improved by increasing the wall thickness or selecting a material with higher hardness, for example, Pebax7233 is adopted, so that the large-scale quick movement is realized, sufficient axial pushing force is provided, and the operation is convenient.
The hardness of the second-stage sheath 22 is between that of the first-stage sheath 21 and that of the third-stage sheath 23, for example, Pebax4033 is adopted, and the function of transition connection is achieved.
In order to ensure the ductility and strength of the sheath 20, in a preferred embodiment, the sheath 20 is designed with three layers, which are a polyurethane material, a woven mesh structure and a PTFE material in sequence from the outside to the inside.
A plurality of pipelines are arranged in the sheath tube 20 in a penetrating way, one end of the pipeline extends into the adsorption head 30, the other end of the pipeline passes through the handle 10 and continues to extend out of the handle 10, and corresponding devices (such as a suction device, a cleaning device, a puncture needle 40 and the like) are connected. Of course, the sheath 20 may be provided with a plurality of channels instead of the connecting function of the pipeline.
In one embodiment, as shown in fig. 5 and 6, the first pull wire 151 and the second pull wire 152 are disposed radially opposite each other along the sheath 20, and the third pull wire 153 is disposed between the first pull wire 151 and the second pull wire 152 circumferentially around the sheath 20.
The first traction wire 151 and the second traction wire 152 are in a mutual linkage relationship, and the linkage relationship is that when the first traction wire 151 slides towards the near end, the second traction wire 152 slides towards the far end, so that the first traction wire 151 and the second traction wire 152 are prevented from being stretched reversely when bending is adjusted, bending resistance is increased, and potential safety hazards exist.
The bending adjustment in one direction is controlled by the traction wires 15, and the bending adjustment in three radial directions is realized by the three traction wires 15. The specific position relationship of the three parts can also be matched with the structure and the use characteristics of the adsorption head 30, the adsorption head 30 can be more finely controlled to change the position in the positioning process or when the treatment position is switched, and the pitching attitude of the adsorption head 30 is further controlled on the basis of conventional bidirectional swinging.
As shown in fig. 8 and 9, the bending direction of the third pulling wire 153 is perpendicular to the bending direction of the first pulling wire 151 and the second pulling wire 152, so that the bending range of the distal end of the sheath 20 is wider. Meanwhile, the sheath tube 20 can be bent between the third traction wire 153 and the first traction wire 151 or the second traction wire 152, so that the operator can adjust the bending direction of the sheath tube 20 more flexibly.
In one embodiment, the distal end of the sheath tube 20 is provided with the suction head 30, the suction head 30 has a suction port 38 on one side in the radial direction of the suction head, and the extending direction from the distal end to the proximal end is taken as the axial direction of the suction head.
Generally, the insertion path direction and the insertion direction of the puncture have a certain included angle, the curvature radius is larger when the distal end of the insertion device 100 is bent as a whole, the operation space is limited, the puncture needle 40 is thinner, and the curvature radius is smaller when the distal end is bent, so that it is preferable that the puncture needle 40 is turned to adapt to the insertion direction, and the adsorption head 30 is arranged at one side in the radial direction, so that the puncture needle 40 is directly extended out of the adsorption head 30 to perform the puncture after being turned. Of course, the entire distal end of the interventional device 100 can also assist in bending to adapt to the interventional path or fine control to target.
The orientation of the suction port 38 coincides with the circumferential position of the third drawing wire 153 with respect to the sheath 20.
The adsorption head 30 is bent toward the side of the adsorption port 38 by means of the third traction wire 153, so that the adsorption head 30 can be conveniently adsorbed on the tissue and organ.
In one embodiment, as shown in fig. 5, 6 and 7, the pull wire 15 is connected to the distal end of the sheath 20 by: a fixing ring 24 is arranged in the sheath tube 20 and adjacent to the distal end of the sheath tube, the fixing ring 24 forms a positioning groove 241 through self deformation and/or local cutting, and the distal end of the traction wire 15 is placed in and fixed in the positioning groove 241. Compared with a welding mode, the fixing mode of the traction wire 15 and the sheath tube 20 through the fixing ring 24 is firmer, and meanwhile, welding spots can be prevented from being generated on the inner wall of the sheath tube 20.
Because each traction wire 15 circumference interval distribution, consequently pulling one of them time can change the orientation of sheath pipe 20 distal end, controllable direction is more when looking for the target spot and other operations, can change sheath pipe 20 distal end orientation fast in order to accord with the anticipated gesture, moreover, because traction wire 15 is more in quantity, also proposed further requirement to its joint strength with sheath pipe 20, adopt the distal end of all traction wires 15 of solid fixed ring 24's mode disposable connection in this embodiment, gu fixed ring 24 rethread hot melt mode is connected with sheath pipe 20 and can guarantee intensity, eliminate the potential safety hazard, more importantly can improve the coordination and the synchronization of many traction wires 15 simultaneous operation.
The fixing ring 24 is in a circular ring shape, the outer peripheral surface of the fixing ring is matched with the inner wall of the sheath tube 20, the sheath tube 20 is shrunk and clamped on the fixing ring 24 through a thermal shrinkage process, and the inner wall of the sheath tube 20 is melted and bonded on the fixing ring 24, so that the assembly is convenient.
The quantity of constant head tank 241 is the same with the quantity of haulage wire 15, is two at least promptly, and constant head tank 241 is for following solid fixed ring 24 axial extension end to end, makes things convenient for wearing to establish and the inlay card of haulage wire 15 in constant head tank 241, plays the positioning action of primary importance haulage wire 15. The positioning groove 241 and the pull wire 15 are fixed to each other by spot welding. The positioning groove 241 may be obtained by machining or may be integrally punched with the fixing ring 24.
Of course, in other embodiments, the pull wire 15 is connected to the distal end of the sheath 20 (first segment sheath 21) by: the traction wire 15 is welded on the inner wall of the sheath tube 20, and the welding mode can reduce the assembly difficulty of the traction wire 15 and the sheath tube 20.
In one embodiment, the fixing ring 24 has a plurality of radially outwardly protruding or inwardly recessed deformation portions distributed at intervals along the circumferential direction, and the deformation portions form positioning grooves 241 on the outer side of the fixing ring 24.
The deformation part is formed by the self deformation of the fixing ring 24 protruding outwards or inwards, is attached to part of the outer edge surface of the traction wire 15 and is used for installing and positioning the traction wire 15, and the installation is convenient.
In one embodiment, the fixing ring 24 has a plurality of radially outwardly protruding or inwardly recessed deformation portions distributed at intervals along the circumferential direction, and the deformation portions form positioning grooves 241 on the inner side or the outer side of the fixing ring 24.
The deformation part is formed by the deformation of the fixing ring 24 and protrudes or dents outwards and inwards, and is integrally processed, the number of parts is small, the part does not need to be assembled, the use of raw materials can be saved, and the efficiency can be improved. When the deformation portion protrudes outward, the deformation portion is a positioning groove 241 on the inner side of the fixing ring 24, and if the deformation portion is recessed inward, the deformation portion is a positioning groove 241 on the outer side of the fixing ring 24. The smooth transition of the deformation portion and other portions of the fixing ring 24 improves the structural strength of the fixing ring 24, and the smooth transition can prevent the traction wire 15 or other adjacent components from being scratched.
In one embodiment, the positioning groove 241 has a U-shaped cross section and a depth corresponding to the diameter of the pull wire 15.
The cross-sectional shape of the positioning groove 241 is adapted to a part of the outer edge of the traction wire 15, and an opening is formed in the positioning groove, so that the traction wire 15 can be directly clamped and embedded from the radial direction of the fixing ring 24. In a preferred embodiment, the positioning groove 241 is recessed, the depth of the groove of the positioning groove 241 enables the surface of the fixing ring 24 to have no convex point after the traction wire 15 is installed, and the depth of the positioning groove 241 is the same as the diameter of the traction wire 15, so that the outer surface of the sheath tube 20 is smooth after the sheath tube 20 is fixed by heat shrinkage.
As shown in fig. 6 and 5a, in one embodiment, an isolation sleeve 25 is sleeved outside the pull wire 15, the isolation sleeve 25 is fixedly arranged relative to the sheath 20, and the pull wire 15 is slidably fitted relative to the isolation sleeve 25.
The isolation sleeve 25 is a hollow circular tube, the outer peripheral surface of the isolation sleeve is fixed with the sheath tube 20 in an adhesive or hot melting mode, the melting point of the isolation sleeve 25 is larger than that of the sheath tube 20, and when the sheath tube 20 is subjected to hot melting operation, the isolation sleeve 25 still keeps the shape of the isolation sleeve to allow the traction wire 15 to slide relatively. The pull wire 15 can slide along the inner hole of the isolation sleeve 25, thereby avoiding the circumferential dislocation of the pull wire 15 and preventing the sheath tube 20 from being cut after the pull wire 15 is tightened.
In one embodiment, the isolation sleeve 25 is attached to the inner wall of the sheath 20, or the liner 26 is thermally fused to the inner wall of the sheath 20, and the isolation sleeve 25 is fixed in the interlayer between the sheath 20 and the liner 26.
Liner tube 26 is hollow pipe, and the hole wears to establish other parts as the passageway, and liner tube 26 periphery is used for supporting barrier sleeve 25, relies on the fixed sheath pipe 20 of pyrocondensation again for barrier sleeve 25 is fixed by the centre gripping, can improve joint strength and prevent the unnecessary dislocation. The liner 26 separates the internal components from the isolation sleeve 25, protecting the isolation sleeve 25, and further protecting the pull wires 15. Through the adapted tooling, the isolation sleeve 25 can be fixed on the periphery of the liner tube 26 in advance through gluing so as to be further fixed with the sheath tube 20 through hot melting.
As shown in fig. 5b, in one embodiment, the outer circumference of the fixing ring 24 is attached to the inner wall of the sheath tube 20, or the liner tube 26 is thermally fused on the inner wall of the sheath tube 20, and the fixing ring 24 is fixed in the interlayer between the sheath tube 20 and the liner tube 26.
The liner tube 26 is penetrated through in advance through a tool, the fixing ring 24 is sleeved on the outer wall of the liner tube 26, the liner tube and the fixing ring are in clearance fit, the gap is coated with glue and fixed, the sheath tube 20 is sleeved on the outermost layer, the sheath tube 20 is shrunk through a heat shrinkage process to combine the liner tube 26, the fixing ring 24 and the sheath tube 20 are clamped and fixed, no matter the traction wire 15 is positioned on the outer side or the inner side of the fixing ring 24, the opening of the positioning groove 241 can be closed as far as possible, the traction wire 15 is shielded inside the positioning groove 241, the clamping and fixing mode can improve the strength, and the phenomenon that the local stress is large and the traction wire is torn during traction is avoided.
In one embodiment, as shown in fig. 3 and 4, the first bending chamber 182 is located near the distal end of the handle 10 relative to the second bending chamber 13;
the driving disc 50 is provided with two wire slots 52 which are communicated or isolated from each other, the first traction wire 151 and the second traction wire 152 are respectively wound on the driving disc 50 through the corresponding wire slots 52, and the traction wire 15 is arranged in the wire slots 52, so that the traction wire 15 can be prevented from being separated from the driving disc 50 when the driving disc 50 rotates.
The third drawing wire 153 passes through the first bending adjusting chamber 182 on the side of the driving disc 50 opposite to the two wire slots 52 and extends to the second bending adjusting chamber 13, the second bending adjusting chamber 13 is communicated with the first bending adjusting chamber 182 through a communication hole (not shown), and after passing through the first bending adjusting chamber 182, the third drawing wire 153 extends to the second bending adjusting chamber 13 through the communication hole and is connected with a linkage piece positioned in the second bending adjusting chamber 13.
During the rotation of the driving disc 50, the groove wall of the wire groove 52 is prevented from tearing the third pull wire 153, which affects the bending of the distal end of the sheath tube 20.
In one embodiment, as shown in fig. 10 and 11, the wire slots 52 are distributed around the outer periphery of the driving disk 50 or are formed on the disk surface of the driving disk 50.
In one embodiment, at least a portion of the first and second traction wires 151 and 152 is wound around the outer periphery of the driving disk 50 or around the linear groove 52 on the axial disk surface of the driving disk 50.
In the present embodiment, each of the wire grooves 52 is opened on the disk surface of the drive disk 50. The disc surface of the drive disc 50 may be understood as one of the end surfaces of both axial ends of the drive disc 50. When the wire groove 52 is opened on the disk surface of the drive disk 50, the extending path of the wire groove 52 may be a straight line or a curved line (e.g., an arc). The wire slot 52 has a head end and a tail end along the extending path, and the proximal end of the traction wire 15 is penetrated through the head end of the wire slot 52 and extends to the tail end of the wire slot 52.
In one embodiment, as shown in fig. 10 and 11, the wire groove 52 includes an arc-shaped segment 521 and a turning segment 522, the arc-shaped segment 521 extends around the center of the driving disc 50, and the turning segment 522 is abutted with the arc-shaped segment 521 and extends toward the middle of the driving disc 50.
After entering through the arc-shaped section 521, the traction wire 15 extends to the turning section 522 and is fixed. During the rotation of the driving disc 50, the arc segment 521 changes position with the driving disc 50 to drive the traction wire 15 to move. The arc-shaped section 521 makes the operation of the pulling wire 15 more stable, and the sudden change of the speed of the pulling wire 15 does not occur, which may cause the precision of the bending of the distal end of the sheath tube 20 to be reduced.
The extending directions of the turning sections 522 of the two wire grooves 52 are parallel or oblique, and the two turning sections 522 are close to each other. Meanwhile, since the turning section 522 extends to the middle of the driving disc 50, the space of the wire slot 52 occupying the disc surface of the driving disc 50 in the length direction is shortened, so that the structure of the driving disc 50 is more compact.
In one embodiment, as shown in fig. 10 and 11, the radial position of the arc 521 is located in the middle of the driving disc 50 or adjacent to the edge of the driving disc 50, the arc 521 of the two slots 52 are located at two opposite sides of the driving disc 50 in the radial direction, and the first traction wire 151 and the second traction wire 152 are in a linkage relationship with each other, in which when the first traction wire 151 moves proximally, the second traction wire 152 moves distally, so as to avoid the first traction wire 151 and the second traction wire 152 from being stretched reversely during bending adjustment, which not only increases the bending resistance, but also has a safety hazard.
In one embodiment, as shown in fig. 10 and 11, the central angle of the arc 521 is 60 to 120 degrees;
the arc-shaped section 521 is provided with a wire inlet 523, and the wire inlet 523 faces to the far end side in the non-bending state.
Two arc sections 521 communicate each other at the one end that goes into the line mouth 523 dorsad, and the central angle that the arc section 521 corresponds is under this scope, and driving-disc 50 is in initial condition (sheath pipe 20 is in under the non-accent curved state), has certain interval between the income line mouth 523 of two wire casings 52, and this interval can avoid driving-disc 50 pivoted certain angle after, and first pull wire 151 and second pull wire 152 syntropy move, can cause first pull wire 151 and second pull wire 152 to take place reverse stretch when transferring the curve.
Preferably, the central angle corresponding to the arc-shaped section 521 is 80-100 degrees.
Most preferably, arcuate segment 521 subtends an angle of 90 degrees at its center.
In the connection of the pull wire 15 to the drive disk 50, referring to one embodiment, as shown in fig. 12, the end of the turn 522 is the positioning region 53, and the proximal end of the pull wire 15 is secured to the positioning region 53 by the mounting member 54.
The traction wire 15 is firstly connected with the mounting member 54 (for example, the traction wire 15 is fixed on the mounting member 54 by bolting), and then the mounting member 54 is clamped on the positioning area 53, so that the traction wire 15 is rapidly fixed on the driving disc 50, and the difficulty in mounting the traction wire 15 and the driving disc 50 can be reduced.
Wherein, location district 53 is the groove structure, and location district 53 is linked together with the terminal of wire casing 52, and the installed part 54 block is located this location district 53. The locating region 53 may be machined with the wire chase 52 to reduce the machining process of the drive disc 50.
Wherein the mounting member 54 is generally block-shaped. The outer profile of the positioning region 53 is substantially congruent with the outer profile of the mounting member 54 (preferably an interference fit between the mounting member 54 and the positioning region 53) to prevent the mounting member 54 from disengaging from the positioning region 53 when the mounting member 54 is subjected to the force of the pull wire 15.
Of course, in other embodiments, the traction wire 15 may be fixed to the driving disk 50 by welding, gluing, etc., and will not be described herein.
Preferably, the positioning area 53 is located on the disc surface of the drive disc 50.
The handle 10 provides support for the various components while also providing room for the operator to grasp. In order to facilitate forming the first bending adjustment chamber 182 on the handle 10, referring to an embodiment, as shown in fig. 3, the handle 10 has a first housing 18 and a second housing 181, the first housing 18 and the second housing 181 are buckled with each other to enclose the first bending adjustment chamber 182, and the sheath 20 is fixed between the first housing 18 and the second housing 181.
In order to reduce the difficulty in assembling the first casing 18 and the second casing 181, the first casing 18 and the second casing 181 may be fixed by screws or by clamping.
To facilitate the operation of the driving disc 50, referring to an embodiment, as shown in fig. 2 and 3, the handle 10 is provided with an operation slot 183 communicated with the first bending chamber 182; the driving disk 50 has a driving handle 51 at its periphery, and the driving handle 51 extends from the operating slot 183 to the first bending chamber 182. The operator holds the portion of the driving handle 51 located outside the first bending adjusting chamber 182, and then drives the driving disk 50 to rotate through the driving handle 51, so that the operator can control the driving disk 50 to rotate.
The driving lever 51 is substantially in the shape of a rod, and the driving lever 51 and the driving disk 50 are provided separately or integrally. In the present embodiment, the number of the driving levers 51 is two, the number of the operation slots 183 is two, and the two driving levers 51 are located at opposite sides of the driving disc 50 and respectively pass through the corresponding operation slots 183. Of course, in other embodiments, the number of the driving levers 51 may be 1, 3, or 3 or more.
An operating slot 183 extends proximally along the distal end of handle 10 such that when drive shaft 51 rotates drive disc 50, drive shaft 51 is able to move within operating slot 183. In order to reduce the processing difficulty of the operation slot 183, the operation slot 183 is located at the connection between the first housing 18 and the second housing 181.
In one embodiment, as shown in fig. 4 and 13 to 16, the handle 10 includes a support 11 and a rotary handle 12 rotatably mounted on the periphery of the support 11, a second bending chamber 13 is defined between the support 11 and the rotary handle 12, a linkage 14 is slidably engaged with the support 11, and a proximal end of the third pull wire 153 is connected to the linkage 14 and is used for pulling the suction head 30 to move toward the side where the suction port 38 is located.
In this application, the art person is through rotating rotatory handle 12, and rotatory handle 12 drives linkage 14 and slides on supporter 11 to it is crooked to drive the distal end that the traction wire 15 drew sheath pipe 20, and it is crooked towards fixed direction to drive adsorption head 30 at last, so that adsorption head 30 avoids the tissue organ, reduces the damage to the tissue organ.
The outer circumference of the link 14 is provided with an external thread, and the inner wall of the swing handle 12 is provided with an internal thread matching the external thread.
The screw connection between the rotating handle 12 and the link 14 can convert the rotation of the rotating handle 12 into the sliding of the link 14 on the supporting body 11, so as to stabilize the movement of the link 14. Meanwhile, the self-locking phenomenon of the linkage part 14 can be realized, and the linkage part 14 is prevented from being driven to move by the resetting force of the sheath tube 20.
In one embodiment, the supporting body 11 defines a guiding groove 111 extending along the axial direction of the sheath 20, the link 14 is slidably mounted in the guiding groove 111, and the guiding groove 111 can define a moving path of the link 14, so as to move the link 14 in a fixed direction.
At least part of the link 14 is located in the guide groove 111 and can slide along the guide groove 111, and the part of the link 14 extending out of the guide groove 111 is provided with an external thread (the external thread is matched with the internal thread of the rotary handle 12). In order to stabilize the sliding of the link 14, the link 14 is attached to both side walls of the guide groove 111 along both axial sides of the sheath 20, so that the link 14 is prevented from wobbling in the guide groove 111 in the radial direction of the sheath 20, thereby reducing the bending accuracy of the sheath 20.
The support 11 may be made of metal or medical plastic material, the support 11 is a cylinder and has an axis which is consistent with the axis of the sheath 20, the support 11 is provided with a through hole 112 penetrating along its own axis, and the through hole 112 is used for each tube (such as the puncture needle 40, etc.) to pass through. The outer side wall of the supporting body 11 has two oppositely disposed guiding plates 113, the guiding groove 111 is formed between the two guiding plates 113, and the two guiding plates 113 are disposed in parallel or at an included angle.
In one embodiment, the orientation of the suction port 38 is consistent with the circumferential position of the guide groove 111 relative to the support body 11, and when the traction wire 15 is inserted into the sheath tube 20, the traction wire 15 is always attached to the inner wall of the sheath tube 20, so that the traction wire 15 is retracted from each tube in the sheath tube 20.
In terms of the connection manner of the traction wire 15 and the linkage member 14, referring to an embodiment, the linkage member 14 is provided with a threading hole 142 axially penetrating along the sheath 20, and the traction wire 15 is adhered in the threading hole 142. The far end of the traction wire 15 is arranged in or penetrates through the threading hole 142, and the traction wire 15 part positioned in the threading hole 142 is glued on the inner wall of the threading hole 142 through glue, so that the structure between the traction wire 15 and the linkage piece 14 is simplified, and the assembly difficulty between the traction wire 15 and the linkage piece 14 is reduced.
The threading hole 142 is located at a portion of the link 14 disposed in the guide groove 111, and the cross-sectional shape of the threading hole 142 is not strictly limited in the present embodiment, and may be, for example, circular or oval.
Of course, in other embodiments, the connection of both the pull wire 15 and the linkage 14 is by: the near end of the traction wire 15 passes through the threading hole 142 and is tied, the knot is limited by the threading hole 142, when the traction wire 15 is acted by the acting force on the sheath tube 20, the knot on the traction wire 15 cannot pass through the threading hole 142, and the knot can be fixed on the linkage piece 14 through the structure of the traction wire 15, so that the difficulty of assembling the traction wire 15 and the linkage piece 14 is further reduced.
Alternatively, the proximal end of the pull wire 15 passes through the threading hole 142 and is connected to a retaining member (not shown) that is limited to the threading hole 142. The shape of anticreep piece does not have strict restriction, as long as when the pull wire 15 receives the effort pulling anticreep piece of sheath pipe 20, the anticreep piece can not pass through threading hole 142, and the bolt is on the anticreep piece after pull wire 15 passes threading hole 142, and the setting of anticreep piece can increase the joint strength between pull wire 15 and the linkage 14.
In order to limit the relative movement between the anti-slip part and the linkage part 14, in one embodiment, a groove (not shown) is provided at the proximal end (the end close to the operator) of the linkage part 14, the groove is located at the threading hole 142, and the shape of the anti-slip part is substantially consistent with the shape of the groove, so that the anti-slip part is embedded in the groove. To facilitate the connection of the traction wire 15 to the anti-release member, the traction wire 15 is bolted to the anti-release member.
In the connection manner of the rotating handle 12 and the handle 10, referring to an embodiment, the rotating handle 12 is cylindrical, the handle 10 is provided with two rotating grooves 161 located at two ends of the rotating handle 12, and two axial ends of the rotating handle 12 respectively extend into the corresponding rotating grooves 161 and are rotatably mounted on the handle 10, so as to avoid additional components such as a support frame for supporting the rotating handle 12 on the handle 10, and simplify the structure of the handle 10.
The axis of the rotating handle 12 coincides with the axis of the sheath 20. The outer side wall of the rotating handle 12 is higher than, lower than or flush with the outer side wall of the handle 10, and in order to facilitate the operation of the rotating handle 12 by the operator, in the present embodiment, the outer side wall of the rotating handle 12 is higher than the outer side wall of the handle 10.
In the connection manner of the rotating handle 12 and the handle 10, referring to an embodiment, the handle 10 has two mounting rings 16 at both ends of the rotating handle 12, and the supporting body 11 is mounted in the handle 10 and forms two rotating grooves 161 with the respective mounting rings 16, thereby further simplifying the assembly structure between the rotating handle 12 and the handle 10.
When the supporting body 11 is located in the rotating handle 12, two ends of the supporting body 11 respectively extend out of the rotating handle 12, so that part of the structure of the supporting body 11 can extend to the mounting ring 16, two ends of the supporting body 11 are provided with supporting shoulders 114 opposite to the mounting ring 16, and the supporting shoulders 114 and the mounting ring 16 form a rotating groove 161.
In the installation manner of the support body 11 and the handle 10, referring to an embodiment, the outer side wall of the support body 11 is provided with a limiting shoulder 115, the inner side wall of the handle 10 is provided with a limiting groove (not shown) matched with the limiting shoulder 115, and the limiting shoulder 115 not only positions the installation position of the support body 11 in the handle 10, but also pre-installs the support body 11 in the handle 10.
The mounting ring 16 and the handle 10 are integrally or separately arranged. In order to facilitate the assembly of the mounting ring 16 and the handle 10, in the present embodiment, the mounting ring 16 and the handle 10 are provided separately.
One end of the communication hole communicates with the through hole 112, and the other end communicates with the guide groove 111.
Alternatively, in other embodiments, the mounting gap between the mounting ring 16 and the stop shoulder 115 forms a communication aperture.
In order to facilitate the handle 10 for the operator, referring to an embodiment in which the rotation axis of the driving disk 50 is perpendicular or oblique to the axis of the rotation handle 12, when the operator adjusts the driving disk 50 and the rotation handle 12, one hand of the operator holds the handle 10 and operates the rotation handle 12, and the other hand can separately operate the driving disk 50 to facilitate the operation of the driving disk 50 and the rotation handle 12.
In one embodiment, referring to fig. 26, the working chamber 31 is arranged as an integral chamber or includes a plurality of sub-chambers communicating with each other inside the adsorption head 30, the adsorption passage 321 and the operation passage 33 are respectively communicated with the corresponding sub-chambers, and the adsorption port 38 is communicated with at least the sub-chamber where the operation passage 33 is located.
The inside of a plurality of son cavities communicates with each other for all son cavities in the working chamber 31 all can be through with adsorb passageway 321 intercommunication, produce the negative pressure in the working chamber 31 through suction device, rely on inside and outside pressure difference to form the adsorption affinity and adsorb in the adsorbate, avoid leading to adsorption head 30 to break away from the adsorbate because of the top of pjncture needle 40 is moved. Preferably, the working chamber 31 may also be a body chamber, i.e. there is sufficient space for arranging auxiliary components, and it is also possible to avoid clogging problems due to narrow communication sites.
The adsorption passage 321 may be disposed along the axial direction, or may be disposed in a curved manner, and the cross-sectional shape of the adsorption passage 321 may be circular or elliptical. In order to facilitate the processing of the adsorption channel 321 on the adsorption head 30, a vacuum tube 32 is arranged on the adsorption head 30, the internal channel of the vacuum tube 32 is the adsorption channel 321, one end of the vacuum tube 32 extends into the working cavity 31, the other end of the vacuum tube penetrates through the sheath tube 20 and is connected to the suction device, and the medium in the working cavity 31 is sucked and discharged out of the adsorption head 30 through the suction device.
The operation channel 33 is a channel for installing the puncture needle 40.
In order to better perform the bending puncture operation, referring to an embodiment, as shown in fig. 24 and 25, the puncture needle 40 used in the suction head 30 of the present application includes a guide tube 41, a needle tip 42, an inner needle tube 43, and an outer needle tube 44, wherein the guide tube 41 is a hollow metal tube, the outer needle tube 44 is connected to the proximal end of the guide tube 41, or the outer needle tube 44 and the guide tube 41 are integrally formed.
The inner needle tube 43 is slidably mounted within the outer needle tube 44 and the distal end of the inner needle tube 43 is connected to the needle 42, although the needle 42 may be integral with the inner needle tube 43. When the inner needle tube 43 is moved, the needle 42 is caused to change along the shape of the guide tube 41, facilitating the curved puncture.
Since the operating space in the human body is limited, the puncture needle 40 should perform a bending puncture to reduce damage to the tissue organ in order to reduce damage to the tissue organ. In one embodiment, as shown in fig. 29, the connection portion between the operation channel 33 and the working chamber 31 is a first connection port 37, and the first connection port 37 is located on the side of the working chamber 31 away from the adsorption port 38.
The first communication port 37 is a passage port of the puncture needle 40 into the working chamber 31, and the puncture needle 40 needs to be bent and inclined toward the suction port 38 after entering the working chamber 31, and in order to secure a preferable puncture angle, a sufficient bending and inclination space must be left, and for this reason, the first communication port 37 is positioned as far as possible from the suction port 38 side.
In a preferred embodiment, one side of the suction port 38 is defined as the bottom of the suction head 30, and the first communication port 37 is provided at the top of the suction head 30.
In one embodiment, as shown in fig. 31, the distal end side of the inner wall of the working chamber 31 is a guiding portion 36, and the guiding portion 36 gradually curves and transitions from the first communication port 37 to the distal end side of the suction port 38.
The guide portion 36 is an open slot, which opens toward the side of the suction port 38, and the guide portion 36 is divided into a front section and a rear section, wherein the front section is a guide groove 361 extending along the operation channel 33, and the rear section is a curved groove 362 smoothly curved toward the suction port 38 next to the guide groove 361. The guide tube 41 of the puncture needle 40 is substantially in contact with the guide portion 36, and has, for example, an arc shape or an elliptical arc shape.
The outlet end of the guide tube 41 can be away from the adsorption port 38 by a certain distance, that is, the needle 42 is still in the working cavity 31 after extending out of the guide tube 41 and does not penetrate into the adsorbed object, thereby facilitating observation and confirmation of the puncture point.
In a complicated operation process, when a tissue organ is punctured, the puncturing direction of the puncture needle 40 forms an included angle with the tangent plane of a target point (i.e. the plane of the adsorption port 38), and in order to protect the tissue organ, the puncturing depth is reduced as much as possible, namely the included angle is as close to 90 degrees as possible. In one embodiment, the guide tube 41 is 1/4 arc or ellipse, i.e., at a 90 ° angle, such that the piercing needle 40 pierces perpendicular to the surface of the adsorbate. The damage to the needle 42 is reduced and the length of the needle 42 penetrating the myocardial tissue is minimized, with minimal damage to the tissue and organs.
Due to the volume limitation of the puncture needle 40, when the needle head 42 slides and bends in the guide tube 41, frictional resistance exists between the needle head 42 and the inner wall of the guide tube 41, and if the included angle is too large, the needle head 42 is not pushed or pulled, and the puncture operation is affected. As shown in fig. 33, in the preferred embodiment, the included angle is 45 ° to 60 °, so that the frictional resistance is reduced, and the operation by an operator is facilitated.
When the arrangement mode of the working chamber 31 is a plurality of sub-chambers, in one embodiment, a partition plate is provided between two sub-chambers adjacent to each other, and the two sub-chambers adjacent to each other are communicated with each other through a through hole provided in the partition plate, or the two sub-chambers adjacent to each other are communicated with each other through a pipeline.
The partition plate is arranged perpendicular to the adsorption port 38, and the plurality of sub-chambers are separated to be connected with different channels, for example, the operation chamber is connected with the operation channel, and the adsorption chamber is connected with the adsorption channel. Interference between the chambers is avoided. Each chamber is communicated with each other through a pipeline or an opening, so that after the adsorption cavity is vacuumized, other chambers can be also vacuumized, and all the adsorption ports 38 generate adsorption force. Compared with the prior adsorption head, the adsorption head 30 is prevented from being separated from the adsorbate due to the pushing of the puncture needle 40 during the puncture operation, thereby avoiding the influence on the operation.
Since the surface of the adsorbate is very easy to be damaged, during the adsorption operation, the adsorbate protrudes and extends into the adsorption port 38, so as to avoid damaging the surface of the adsorbate, in one embodiment, the edges of the adsorption port 38 are on the same plane or on a cambered surface with the middle part depressed towards the inside of the adsorption port.
The position of the cross-sectional shape of the adsorption port 38 close to the inner side of the adsorption port 38 is an arc surface, so that the adsorbed object is protruded into the adsorption port 38 and then attached to the arc surface, and the object is prevented from being scratched.
As shown in fig. 29 and 29a, in one embodiment, the periphery of the suction port 38 is provided with a sealing lip 39 protruding to abut against the article to be sucked.
The seal lip 39 may be formed integrally with the suction port 38, or may be assembled as a separate part, and the cross-sectional shape thereof is a semicircular shape or other shape without a sharp corner, thereby preventing scratching of the object to be sucked. The sealing lip 39 is mainly used to better isolate the outside air and liquid from entering the working chamber 31 when the adsorption port 38 is attached to the surface of the adsorbate, so as to prevent the adsorption head 30 from separating from the adsorbate after the outside air enters.
In one embodiment, the sealing lip 39 is annular with a flared rim 391.
The annular structure means that a path which is connected end to end and surrounds the periphery of the adsorption port 38 by a circle exists, the outward extension of the annular structure is provided with the outward flange 391, and the outward flange 391 improves the contact area with the adsorbed object and more effectively blocks the outside gas and liquid.
The outward flange 391 may be of the same thickness throughout the extension process or of different thicknesses. As shown in fig. 29a, in the preferred embodiment, the thickness gradually decreases from inside to outside, and the thickness tends to decrease rapidly, and a flat attaching surface 392 with a smaller thickness is formed at the end, so as to improve the deformation capability of the flat attaching surface 392 and improve the attaching performance with the absorbed object. The flat surface 392 is transitionally connected with the inner wall of the working chamber 31 through the inner edge 393 of a smooth cambered surface, so that the absorbed object is prevented from being scratched.
In one embodiment, the opening of the adsorption port 38 is a communication area or is divided into a plurality of unit areas.
When the depth of the partition plate does not extend to the plane of the adsorption port 38 or the working cavity 31 is an integrated cavity, the opening of the adsorption port 38 is a communication area, and all positions of the adsorption port 38 can generate adsorption force for adsorbing an adsorbate, so that the phenomenon that the adsorption head 30 falls off due to the pushing of puncture and the influence on the operation is avoided.
When the depth of the partition extends to the same plane as the adsorption port 38, the adsorption port 38 is divided into a plurality of unit regions. When the vacuum is generated in the working chamber 31, the adsorbate will partially bulge into the adsorption port 38, so that the penetration depth is uncertain. Therefore, the partition plates are arranged in a partition mode, the area of the adsorption port 38 of the operation cavity is reduced, and then the bulge of the adsorbed object is reduced, so that the puncture operation is more accurate. And each chamber is communicated with each other, and the adsorption port 38 of each unit area can generate adsorption force, so that the phenomenon that the adsorption head 30 falls off due to the pushing of puncture to influence the operation is avoided.
In one embodiment, the plurality of unit regions are formed in a regularly distributed grid structure or a random porous structure.
The plane of the adsorption port 38 is provided with a flat plate with a grid structure or flexible cloth with a porous structure, and a puncture space is reserved in holes of the porous structure, so that the puncture of the puncture needle 40 is facilitated. And further separate absorption mouth 38 for the height that the adsorbate arch stretched into absorption mouth 38 reduces, protects the adsorbate, and simultaneously, the control of puncture depth is more accurate.
In one embodiment, the suction port 38 extends a distance proximally along its length (axial direction), and the suction port 38 is opened at one side of the suction head 30 in the radial direction.
Generally, the insertion path direction and the insertion direction of the puncture have a certain included angle, the curvature radius is larger when the distal end of the insertion device 100 is bent as a whole, the operation space is limited, the puncture needle 40 is thinner, and the curvature radius is smaller when the distal end is bent, so that it is preferable that the puncture needle 40 is turned to adapt to the insertion direction, and the adsorption head 30 is arranged at one side in the radial direction, so that the puncture needle 40 is directly extended out of the adsorption head 30 to perform the puncture after being turned. Of course, the entire distal end of the interventional device 100 can also assist in bending to adapt to the interventional path or fine control to target.
In one embodiment, the guide portion 36 has a turning angle of 75-100 degrees in a bending transition relative to the axial direction of the suction head.
The angle of rotation is the angle between the line connecting the start point and the end point of the bend of the guide portion 36 and the axis of the operation channel 33, and the angle of rotation is too small, which easily causes the guide tube 41 to loosen, the outer needle tube 44 is not firmly fixed, and the outer needle tube 44 easily moves synchronously with the inner needle tube 43 during the puncturing process, thereby affecting the puncturing operation. If the rotation angle is too large, the sliding resistance of the needle 42 is too large, and the operator may feel a sliding pause, which affects the smoothness of the puncture. Therefore, the angle of rotation is designed to be 75 to 100 degrees, the puncture angle of the puncture needle 40 is ensured to be 45 to 60 degrees, and the guide tube 41 can be firmly fixed in the guide part 36.
In one embodiment, as shown in fig. 29, the working chamber 31 is a one-piece chamber, the connection portion between the suction channel 321 and the working chamber 31 is a second connection port 371, and the first connection port 37 and the second connection port 371 are both located on the proximal end side of the inner wall of the working chamber 31.
The second communication port 371 is designed close to the suction port 38 so that the vacuum tube 32 is located as close to the suction port 38 as possible when it is inserted into the working chamber 31. During the operation, the medium in the working chamber 31 is sucked from the bottom, and the medium is sucked from the lower position, so that the cleanness of the working chamber 31 is kept as possible.
As shown in fig. 27 and 28, in one embodiment, the proximal end side of the suction head 30 is further provided with an endoscope channel 34 and a cleaning channel 35 which communicate with the working chamber 31, respectively.
The endoscope channel 34 is provided with the endoscope 101 for observing the condition in the working cavity 31, the endoscope channel 34 is divided into a front section and a rear section, the rear section extends along the axial direction of the adsorption head 30, the front section inclines or bends towards one side of the adsorption port 38 and is communicated with the working cavity 31, and after the endoscope 101 is installed along the endoscope channel 34, the lens of the endoscope can be aligned to the adsorption port 38, so that the target point can be conveniently found and the condition in the working cavity 31 can be observed.
During the operation, the medium in the working chamber 31 is sucked from the bottom, and the medium is sucked from the lower position, so that the cleanness of the working chamber 31 is kept as possible. As shown in fig. 27 and 28, in one embodiment, the proximal end side of the suction head 30 is further provided with an endoscope channel 34 and a cleaning channel 35 which communicate with the working chamber 31, respectively. The endoscope channel 34 is provided with the endoscope 101 for observing the condition in the working cavity 31, the endoscope channel 34 is divided into a front section and a rear section, the rear section extends along the axial direction of the adsorption head 30, the front section inclines or bends towards one side of the adsorption port 38 and is communicated with the working cavity 31, and after the endoscope 101 is installed along the endoscope channel 34, the lens of the endoscope can be aligned to the adsorption port 38, so that the target point can be conveniently found and the condition in the working cavity 31 can be observed.
The cleaning channel 35 is used to supply cleaning liquid for cleaning the working chamber 31 and the endoscope 101, and to keep the working chamber 31 and the endoscope 101 clean. In order to effectively keep the lens of the endoscope 101 clean, in one embodiment, the portion of the endoscope channel 34 communicating with the working chamber 31 is a fourth communication port 373, the portion of the cleaning channel 35 communicating with the working chamber 31 is a third communication port 372, and the third communication port 372 is arranged at one or more positions near the top along the periphery of the fourth communication port 373, when necessary, the cleaning tube 102 slowly delivers cleaning fluid, and the cleaning fluid cleans the endoscope 101 from top to bottom.
In another embodiment, the third communication port 372 may be arbitrarily arranged to wash the lens and the working chamber 31 by filling the working chamber 31 with the washing liquid through the washing passage 35 when the lens of the endoscope 101 is contaminated.
In another embodiment, the third communication port 372 is aligned with the lens of the endoscope 101, and directly outputs the cleaning liquid to clean the lens.
After the cleaning, the endoscope 101 and the working chamber 31 are kept clean by sucking the cleaning liquid through the suction passage 321 by the suction device.
Regarding the spatial arrangement of the endoscope channel 34 and the cleaning channel 35, the radial direction of the suction head 30 is divided into three parts, namely a bottom part, a middle part and a top part, perpendicular to the direction of the suction port 38, the suction channel 321 is located at the bottom part, the operation channel 33 is located at the top part, and then the endoscope channel 34 is arranged at the middle part, so that the endoscope 101 can observe the operation of the puncture needle 40 and the visual field covered by the suction port 38.
As shown in fig. 27 and 32, in one embodiment, the suction channel 321, the operation channel 33, the endoscope channel 34, and the cleaning channel 35 are independent from each other or at least two of them are connected together, and the channels are respectively configured as follows: the adsorption head 30 is provided with a hole to form a channel, the far end of the hole is communicated with the working cavity 31, the near end of the hole is opened to be butted with an external pipeline, or a pipeline is arranged in the hole in a penetrating way, the far end of the pipeline is communicated with the working cavity 31, and the near end of the pipeline extends out of the adsorption head 30.
The adsorption channel 321, the operation channel 33, the endoscope channel 34 and the cleaning channel 35 can be selected to be independent or at least two of the channels are connected together according to the actual situation and the connection mode of the near end, so that various channel arrangement schemes are provided.
The gas or liquid flowing through the adsorption channel 321 and the cleaning channel 35 can be transported by passing through the pipeline or connecting the sheath tube 20 at the proximal channel port.
In one embodiment, when the adsorption channel 321 and the cleaning channel 35 are provided with pipelines, the channels can be mutually connected and communicated and freely combined, but the cross section of each channel is shaped to ensure that at least three fixing points which play a role in fixing and guiding the installed equipment or pipelines exist. For example, the cleaning channel 35 is disposed through the cleaning tube 102, the cleaning channel 35 is disposed in parallel with and communicates with the endoscope channel 34,
in another embodiment, when the adsorption channel 321 and the cleaning channel 35 directly flow gas or liquid, they must be independently arranged to avoid the flowing medium from mixing into other pipelines and affecting the operation. For example, the cleaning passage 35 has no cleaning pipe 102, and when the cleaning liquid flows directly through the cleaning passage, a separate pipe is required.
In one embodiment, as shown in fig. 3, a rotating member 19 is installed in the handle 10, wherein the two pulling wires 15 are bent in opposite directions, and the two pulling wires 15 are connected to the rotating member 19 in opposite winding directions.
The rotating part 19 drives the two traction wires 15 to synchronously and reversely move when rotating, so that the two traction wires 15 are prevented from reversely stretching when bending the sheath tube 20, the bending resistance of the sheath tube 20 is prevented, potential safety hazards are avoided, and more bending adjusting angles are provided for the bending adjustment of the sheath tube 20.
In one embodiment, the rotating member 19 has a disk shape, and the rotation axis is perpendicular to the plane of the suction port 38.
In another embodiment, the handle 10 further comprises a locking mechanism 105 for locking or releasing the driving disc 50, the locking mechanism 105 continuously defining the rotation angle of the driving disc 50 or stepwise defining the rotation angle of the driving disc 50.
The art person is through controlling driving-disc 50, drives traction wire 15 when driving-disc 50 rotates, and the distal end position of traction wire 15 drive sheath pipe 20 is crooked, when the distal end position of sheath pipe 20 is crooked to preset position, locks driving-disc 50 through locking mechanical system 105 butt to avoid outside effort mistake to touch driving-disc 50, cause driving-disc 50 to rotate, can influence the distal end of sheath pipe 20 and transfer the angle of bending.
As shown in fig. 17 to 20, the lock mechanism 105 is largely divided into two operation modes, for example, a mode of using the first lock mechanism 60, and the first lock mechanism 60 includes:
and the knob 61 is in threaded fit with the handle 10, at least one part of the knob 61 is exposed outside the handle 10, the knob 61 is far away from or pressed against the driving disk 50 during the rotation of the knob 61, and the driving disk 50 is locked in a pressed state.
When the distal end of the sheath 20 is bent to a predetermined position, the knob 61 is abutted to lock the driving disk 50, so as to prevent the external acting force from touching the driving disk 50 by mistake, so that the driving disk 50 rotates, and the distal end bending angle of the sheath 20 is affected.
In one embodiment, the first locking mechanism 60 further includes an elastic pad 62 pressed between the knob 61 and the driving disc 50, and during the rotation of the knob 61, by pressing the elastic pad 62 to make the driving disc 50 in a pressed state, the elastic pad 62 can prevent the knob 61 from directly pressing the driving disc 50, and at the same time, the friction between the knob 61 and the driving disc 50 is increased to make the locking of the knob 61 more firm.
The elastic pad 62 may be made of rubber or silicone, and when the knob 61 presses against the elastic pad 62, the elastic pad 62 is deformed by a force. The elastic pad 62 is substantially circular in shape and is capable of covering the disk surface of the drive disk 50 (one end in the axial direction of the drive disk 50). Of course, in other embodiments, the shape of the elastic pad 62 may also be oval, rectangular, annular, etc., and the shape of the elastic pad 62 is not strictly limited as long as the elastic pad 62 can increase the friction force between the knob 61 and the driving disk 50.
In one embodiment, the rotation stop portion 621 is disposed on the periphery of the elastic pad 62, the rotation stop groove 184 is disposed on the handle 10 and is engaged with the rotation stop portion 621, and the rotation stop groove 184 and the rotation stop portion 621 are engaged with each other to prevent the rotation force of the knob 61 acting on the elastic pad 62, so as to prevent the elastic pad 62 from rotating with the knob 61.
The rotation stopping groove 184 is opened on the inner wall of the second housing 181. In order to facilitate observing the state of the elastic pad 62 (whether the elastic pad is pressed by the knob 61), referring to an embodiment, the handle 10 is provided with an observation window 185 communicating with the rotation stop groove 184, and the position of the elastic pad 62 is observed through the observation window 185 to deduce the state of the elastic pad 62.
In the embodiment, the number of the rotation stopping portions 621 is two, the number of the rotation stopping slots 184 is two, and the two rotation stopping portions 621 are oppositely disposed on two opposite sides of the elastic pad 62 and respectively matched with the corresponding rotation stopping slots 184. Of course, in other embodiments, the number of the rotation stoppers 621 may be 1, 3, or 3 or more.
In order to further prevent the elastic pad 62 from rotating with the knob 61, in an embodiment, a plurality of grooves 57 are formed on a surface of the driving disc 50 contacting with the elastic pad 62, after the elastic pad 62 is pressed by the knob 61, the elastic pad 62 deforms, and a portion of the deformation of the elastic pad 62 enters the grooves 57 to increase the friction force between the elastic pad 62 and the knob 61.
When the knob 61 is in the initial state (i.e., when the sheath tube 20 is not bent), the extending direction of each groove 57 is substantially aligned with the extending direction of the sheath tube 20, and the extending directions of the grooves 57 are arranged in parallel.
In one embodiment, the first locking mechanism 60 further includes a spacer 63, the spacer 63 is disposed between the elastic pad 62 and the knob 61, the knob 61 presses the elastic pad 62 by driving the spacer 63, and the spacer 63 can transmit the pressing force of the knob 61 to the elastic pad 62. During the rotation of the knob 61, the spacer 63 consumes a part of the rotation force (for example, by means of the gravity of the spacer 63 itself, the friction force between the spacer 63 and the handle 10, etc.), and only a small part of the rotation force of the knob 61 is transmitted to the elastic pad 62, so as to further reduce the rotation force of the knob 61 on the elastic pad 62.
The spacer 63 is substantially cylindrical, and the spacer 63 has two axial ends, one of which abuts against the knob 61 and the other of which abuts against the elastic pad 62. In order to increase the contact surface between the spacer 63 and the elastic pad 62, the end of the spacer 63 facing the elastic pad 62 has an end plate 631, the end surface of the end plate 631 facing away from the spacer 63 contacts the elastic pad 62, and the contour of the end surface of the end plate 631 facing the elastic pad 62 substantially matches the outer contour of the elastic pad 62. Wherein the area of the end surface of the spacer 63 contacting the knob 61 is smaller than the area of the end surface of the end plate 631, the rotating force of the knob 61 acting on the spacer 63 can be reduced, so as to further reduce the rotating force of the elastic pad 62 received by the knob 61.
In the matching manner of the knob 61 and the handle 10, referring to an embodiment, the sidewall of the handle 10 is provided with a driving groove 641 communicated with the first bending chamber 182, the inner wall of the driving groove 641 is provided with an internal thread, the knob 61 is provided with an external thread matched with the internal thread, the driving disc 50 is assembled in the first bending chamber 182 and can be fixed with the first shell 18 or the second shell 181, then the elastic pad 62 and the isolating piece 63 are installed on the handle 10 in sequence through the driving groove 641, and finally the knob 61 is screwed into the driving groove 641. The next step is assembled after the previous component is fixed, so that the problem that the components are required to be matched with each other to assemble when the elastic pad 62, the spacer 63 and the knob 61 are assembled together with the driving disc 50 is solved, and the assembly difficulty of the elastic pad 62, the spacer 63 and the knob 61 is reduced.
In order to satisfy a certain amount of movement of the knob 61, the driving groove 641 needs to have a certain extension length, and at this time, there is a certain requirement for the thickness of the chamber wall of the first bending adjustment chamber 182, so as to increase the size increase of the handle 10 and the waste of the material of the handle 10, in order to solve this problem, referring to an embodiment, the handle 10 is provided with a connecting sleeve 64, the driving groove 641 communicated with the first bending adjustment chamber 182 is arranged in the connecting sleeve 64, the inner wall of the driving groove 641 is provided with an internal thread, the knob 61 is provided with an external thread matched with the internal thread, the connecting sleeve 64 is wholly arranged in the handle 10 or at least partially arranged outside the handle 10 in a protruding manner, and the connecting sleeve 64 can satisfy the requirement for the extension length of the driving groove 641, so as to avoid the increase of the thickness size of the handle 10 and the increase of the material of the handle 10.
A viewing window 185 is located at the connection of the nipple 64 to the handle 10. The axis of the connecting sleeve 64 is substantially coincident with or parallel to the axis of the drive disc 50. The connecting sleeve 64 and the handle 10 are fixed in a split manner or are integrated, and in order to enhance the connecting strength between the connecting sleeve 64 and the handle 10, the connecting sleeve 64 and the handle 10 are integrally arranged.
In one embodiment, the knob 61 includes an acting portion 612 and a cover 611, an external thread is disposed on an outer side portion of the acting portion 612, the acting portion 612 is in threaded connection with the driving groove 641, one end of the acting portion 612 can press against the driving disc 50, and the other end of the acting portion is exposed outside the handle 10; the cover 611 is connected to the acting portion 612 exposed outside the handle 10 and shields the connection between the acting portion 612 and the driving groove 641.
The knob 61 can be screwed into and out of the driving groove 641, and dust can be prevented from entering the driving groove 641.
The action portion 612 is substantially rod-shaped, the cover 611 extends from the end of the action portion 612 in the radial direction and extends toward the handle 10, and the cover 611 and the handle 10 are in clearance fit, and the clearance allowance is adapted to the movement stroke of the action portion 612 in the driving groove 641.
In order to facilitate the operator to operate the knob 61, the outer sidewall of the knob 61 is provided with a plurality of protruding strips 613, and the protruding strips 613 can increase the friction between the operator's hand and the knob 61.
As shown in fig. 21 to 23, the lock mechanism 105 may also be in the form of a second lock mechanism 70, the second lock mechanism 70 including:
a plurality of locking grooves 55 provided in the drive disc 50 along the circumferential direction of the drive disc 50;
the positioning piece 71 is movably installed in the first bending adjusting chamber 182, and the positioning piece 71 is engaged with the corresponding locking groove 55 during the rotation of the driving disc 50.
When the distal end of the sheath tube 20 is bent to a predetermined position, the positioning element 71 is engaged with the corresponding locking groove 55 to lock the driving disc 50, so as to prevent the driving disc 50 from rotating due to the mistaken touch of external acting force on the driving disc 50, which may affect the distal end bending angle of the sheath tube 20.
In one embodiment, the elastic driving member 72 abuts against the positioning member 71 to drive the positioning member 71 to keep engaging with the corresponding locking slot 55, and when the distal end portion of the sheath 20 is bent to a predetermined position, the positioning member 71 engages with the corresponding locking slot 55 under the action of the elastic driving member 72.
In one embodiment, the locking grooves 55 are distributed at intervals around the axis of the driving disc 50, and the central angle of the adjacent locking grooves 55 relative to the center of the driving disc 50 is 5 to 20 degrees, so that the positioning element 71 sequentially passes through the locking grooves 55 distributed at intervals around the axis of the driving disc 50 during the rotation of the driving disc 50, and the smaller the distance between the adjacent locking grooves 55 is, the higher the bending precision of the distal end of the sheath tube 20 is.
Preferably, the central angle of the adjacent locking slots 55 with respect to the center of the driving disc 50 is 8 to 20 degrees.
Most preferably, the adjacent locking slots 55 are angled 15 degrees relative to the center of the drive plate 50.
The angle of the central angle of the adjacent locking grooves 55 with respect to the center of the driving disc 50 may be determined according to the distance from the locking groove 55 to the center of the driving disc 50. The diameter of the drive plate 50 limits the distance of the locking slot 55 to the center of the drive plate 50.
In the present embodiment, the diameter of the drive disc 50 is 20mm to 60 mm.
Preferably, the diameter of the drive disc 50 is between 30mm and 50 mm.
Most preferably, the diameter of the drive disc 50 is 40 mm.
Of course, in other embodiments, the diameter of the driving disc 50 and the central angle of the adjacent locking slots 55 relative to the center of the driving disc 50 can be adjusted according to actual needs, and will not be further described herein.
In one embodiment, at least one of the contact portions of the positioning element 71 and the locking slot 55 is an arc surface structure, so that the positioning element 71 can be separated from the locking slot 55 when the driver rotates the driving disc 50, thereby preventing the positioning element 71 and the locking slot 55 from being locked to each other.
In one embodiment, the matching portion of the positioning element 71 and the locking groove 55 is in a spherical crown shape, wherein the outer surface of the spherical crown is in a cambered surface structure, so that the positioning element 71 and the locking groove 55 can be separated from each other.
To facilitate the machining of the positioning member 71, it is preferable that the positioning member 71 has a spherical shape.
In one embodiment, the positioning members 71 are distributed in pairs, and the two positioning members 71 of the same pair are located on two opposite sides of the driving disc 50 in the radial direction, so that the forces exerted by the positioning members 71 on the driving disc 50 are balanced.
In the present embodiment, three pairs of the positioning members 71 are provided, and the positioning members 71 are spaced apart from each other around the axis of the drive plate 50, and each positioning member 71 engages with the corresponding locking groove 55 during the locking of the drive plate 50. Of course, in other embodiments, the positioning members 71 are one pair, two pairs, or three or more pairs.
In the assembly relationship between the elastic driving member 72 and the handle 10, referring to an embodiment, the inner wall of the first bending adjustment chamber 182 is provided with a mounting post 73, and the elastic driving member 72 and the mounting post 73 are matched in the following manner: the periphery of the mounting post 73 is sleeved with the elastic driving member 72, the mounting post 73 can limit the movement path of the elastic driving member 72, and can support the elastic driving member 72, so that the elastic driving member 72 is prevented from being twisted when the positioning member 71 receives the rotating force of the driving disk 50.
Of course, in other embodiments, the mounting post 73 is hollow and one end of the resilient actuator 72 extends into the mounting post 73.
In order to prevent the positioning member 71 from being separated from the cavity, which may cause the positioning member 71 to be caught between the mounting post 73 and the driving disk 50, referring to an embodiment, the positioning member 71 is movably mounted in the cavity, and at least a portion of the positioning member 71 is exposed outside the cavity, and an inner edge of the cavity is provided with an anti-falling step 731 engaged with the positioning member 71.
In the present embodiment, the elastic drive member 72 is a compression spring.
The indication and control of the travel of the inner needle cannula 43 is an important aid in either puncturing or injecting medication or contrast media, etc., as shown in fig. 1, 34 and 35, wherein some embodiments provide further improvements in the indication and control of the travel of the inner needle cannula 43, such as providing an interventional instrument 100 in one embodiment that includes a handle 10 and a sheath 20, the distal end of the sheath 20 being configured for corresponding configuration and function depending on the interventional objective and treatment protocol. Of course, combinations of the foregoing and embodiments are also possible.
For example, the distal end of the sheath 20 is connected with the suction head 30, the sheath 20 is slidably fitted with an inner needle tube 43 for puncturing or injection, the handle 10 is provided with a driving member 910 connected to the inner needle tube 43 for driving the inner needle tube 43, and during puncturing operation, the driving member 910 drives the puncturing needle to puncture and withdraw from the tissue and organ through the suction head 30.
In the process of puncturing operation, the driving member 910 needs to be pulled back to drive the inner needle tube to retract when switching the treatment position, the conventional device generally needs to unlock the driving member or apply a force to overcome the magnetic attraction, and particularly, the operation is complicated when the treatment position is more.
As shown in fig. 34 to 35, the interventional instrument 100 comprises a handle 10 and an inner needle tube 43, wherein a driving member 910 is slidably mounted on the handle 10, and a portion of the inner needle tube 43 is movably inserted into the handle 10 and connected to the driving member 910. The handle 10 has a distal end and a proximal end opposite to each other, the handle 10 is provided with a scale mark 960 indicating the relative position of the driving member 910, and a positioning member 940 limiting the stroke of the driving member 910, the outer wall of the handle 10 is provided with a plurality of slots 950 along the moving direction of the driving member 910, the positioning member 940 is detachably engaged with each slot 950, and the driving member 910 abuts against the positioning member 940 when moving to a predetermined stroke.
The handle 10 includes a first handle case 901 and a second handle case 902, which are engaged with each other, in a partial region and are held by an operator. The inner needle tube 43 has a moving path in the handle 10, and the inner needle tube 43 is driven by the driving member 910 to slide along the moving path, thereby completing the puncturing operation. The driving member 910 extends partially into the handle 10 to connect with the inner needle tube 43, and partially exposes out of the handle 10 for pushing by the operator. The scale marks 960 are engraved near the driving member 910 by grooving, laser engraving, or painting, and are arranged along the sliding direction of the driving member 910. The operator can conveniently and quickly read the sliding distance of the driving member 910, and then the puncture depth can be judged.
The positioning member 940 is shaped like a column convenient for an operator to pinch, and the positioning member 940 is provided with a matching portion matched with the clamping groove 950. The locking groove 950 is an open groove formed by integrally machining or locally cutting the handle, and the positioning member 940 is inserted into the locking groove 950 through the matching portion along a certain direction, so that the positioning member 940 is detachably connected with the handle 10.
The plurality of slots 950 are arranged in parallel with the sliding direction of the driving member 910 and are located near the sliding path of the driving member 910. The positioning element 940 inserted into the slot 950 is partially or completely inserted into the sliding area swept by the sliding of the driving element 910, and since the positioning element 940 cannot move in directions other than the plugging direction, the pushing and pulling driving element 910 slides until abutting against the positioning element 940 and stopping sliding, and when the inner needle tube 43 is retracted, the driving element can be directly pulled back by applying a force in a reverse direction.
Compared with other prior art locking mechanisms, the present embodiment omits the unlocking operation when the driving member 910 is toggled, and the operation is more convenient. Compared to the prior art of attracting the driving member 910, the jerking feeling due to overcoming the attracting force is eliminated, and the whole operation process maintains the same damping feeling. Because the inner needle tube 43 will generate a certain frictional resistance with the mating part when sliding, the driving member 910 connected to the inner needle tube 43 will not slide relatively without the action of external force, and only the side of the driving member 910 near the distal end is limited. A positioning member 940 is provided at a distal side of the driving member 910 for determining a preset value during puncturing.
As shown in fig. 36, in one embodiment, the handle 10 is a hollow structure, a guide slot 970 is formed on a side wall of the handle 10, and the driving member 910 includes: a first operation portion 911 at least a part of which is located outside the handle 10, and an extension portion 912 which extends from the first operation portion 911 into the interior of the handle 10 via a guide groove 970. The extension portion 912 has an avoiding hole 9121, and the inner needle tube 43 passes through the avoiding hole 9121 and is fixed relative to the avoiding hole 9121.
The handle 10 is hollow to provide space for installing components, to facilitate the insertion of the inner needle tube 43, and the driving member 910 extends into the handle 10 and is fixed to the inner needle tube 43. The first operation portion 911 is a bar or block shape for facilitating the finger to abut against, and has a width larger than that of the guide groove 970, preventing the driving member 910 from falling into the handle 10. The guide slot 970 is a rectangular slot with a length along the axial direction, and the extension portion 912 passes through and extends into the handle 10. Therefore, the extension portion 912 is a column-shaped body corresponding to the guide groove 970 and is disposed at the bottom of the first operation portion 911, and the extension portion 912 and the guide groove 970 are in surface contact, thereby improving the guiding stability. The avoiding hole 9121 is a through hole for penetrating the inner needle tube 43, and is in clearance fit with the inner needle tube 43, and the two are fixed by gluing at the clearance. Extension 912 is disposed within handle 10 in only a connecting relationship with inner needle cannula 43, such that clearance hole 9121 is disposed as close to the bottom side of extension 912 as possible, which facilitates reducing the overall length of extension 912.
The surface of the driving member 910 is provided with a protruding platform 9103 for the operator to lean against and an anti-slip pattern 9104 for increasing the friction force.
As shown in fig. 36, in one embodiment, the first operation portion 911 is a dial button and is slidably attached to an outer wall of the handle 10.
The lower surface of the dial button is always attached to the outer wall of the handle 10, when the driving member 910 is pushed and pulled by the dial button to slide, the outer wall of the handle 10 is always attached to the dial button to provide stable support, and the operation hand feeling is smooth.
As shown in fig. 37 and 38, in one embodiment, a hollow-out region 980 is formed on a sidewall of the handle 10, and the positioning member 940 includes: a second operation portion 941 having at least a portion located at an outer portion of the handle 10, a locking portion 942 located at a bottom portion of the second operation portion 941 and engaged with the locking groove 950, and a blocking portion 943 extending from a bottom side of the second operation portion 941 into an inner portion of the handle 10 through the hollow region 980. The driving member 910 abuts against the stopping portion 943 when moving to a predetermined stroke.
Through setting up fretwork area 980, interference when can avoiding handle casing and setting element 940 to move, fretwork area 980 is the open slot that sets up in first plane area 9005, and draw-in groove 950 sets up in one side of the length direction of fretwork area 980, can follow fretwork area 980 and slide after setting element 940 breaks away from draw-in groove 950, and the different default are adjusted in draw-in groove 950 to the rethread joint, need not to pull out the handle with setting element 940 thoroughly, prevent that the part from scattering.
The second operating portion 941 is cylindrical or other column-shaped, and has a top portion with a raised annular portion 9411 along the periphery thereof, and the raised annular portion 9411 is convenient for an operator to insert and pull the positioning member 940. The second operation portion 941 is partially inserted into the slot 950 through the engaging portion 942, so as to achieve engagement. The stopping portion 943 extends along a bottom surface of the engaging portion 942 until it reaches a sliding area of the driving member 910, so as to limit the movement of the driving member 910.
As shown in fig. 36 to 38, in one embodiment, the hollow area 980 is bar-shaped and extends in a direction consistent with the moving direction of the driving member 910, and the blocking portion 943 has an anti-falling head 944 for limiting the positioning member 940 to fall out of the hollow area 980.
The hollow-out region 980 is a strip-shaped open slot extending axially, and the length direction of the slot is the same as the moving direction of the driving member 910, so that any slot 950 of the positioning member 940 clamped into the hollow-out region 980 extends into the sliding region of the driving member 910, thereby limiting the sliding of the driving member 910. The anti-slip head 944 is a cylindrical structure extending from a portion of the side of the blocking portion 943 to the hollowed-out region 980. The releasing head, the blocking portion 943 and the clamping portion 942 form a C-shaped locking structure, and the thickness of the locking structure is smaller than the width of the hollowed-out area 980, so that the positioning member 940 and the hollowed-out area 980 are in two states of locking and releasing. The disengaged state is that the C-shaped locking structure does not engage the hollowed-out region 980, and the positioning member 940 can be pulled out of the handle 10 and disengaged therefrom. The locking state is that the positioning member 940 extends into the hollowed-out area 980 and rotates 90 degrees, so that the C-shaped locking structure is clamped into the hollowed-out area 980, and when the positioning member 940 is pulled out, the anti-disengaging head 944 is interfered to the hollowed-out area 980 and cannot disengage. The distance between the anti-falling head 944 and the hollowed-out area 980 is greater than the grooving depth of the clamping groove 950, that is, at the moment that the positioning element 940 completely breaks away from the clamping groove 950, the anti-falling head 944 still does not contact the hollowed-out area 980, and the positioning element 940 can move along the hollowed-out area 980 and be installed in other clamping grooves 950 without being detached, so that the positioning element 940 can normally adjust the preset value.
As shown in fig. 39, in one embodiment, the scale markings 960 correspond to the position of the card slot 950.
The positions of the scale marks 960 correspond to the positions of the slots 950 one by one, so that each positioning point of the positioning member 940 has a scale corresponding to each other, and an operator can read data conveniently.
As shown in fig. 40 and 41, in one embodiment, a viewing window 990 is formed on a side wall of the handle 10, the driving member 910 further has an indicator 913 extending to the viewing window 990, and the scale 960 is adjacent to the viewing window 990.
The side wall of the handle 10 is provided with a second planar region 9006, and the viewing window 990 is strip-shaped and extends axially in the second planar region 9006. The scale markings 960 are provided on the second planar region 9006 on one axial side of the viewing window 990. The cross-sectional shape of indicator 913 is trapezoidal, and its upper base is towards one side of scale mark 960, and the size of upper base is close to 0 for the cross-sectional shape of indicator 913 is close to triangle-shaped, and the upper base (close closed angle) aims at the scale, and is corresponding, scale mark 960 is thin strip, combines observation window 990, makes the operating personnel reading more accurate on the one hand, and on the other hand, the puncture depth that scale mark 960 reacted is more accurate.
As shown in fig. 40 to 42, in one embodiment, the indicating member 913 is connected to the extending portion 912, and when the driving member 910 moves to the predetermined stroke, the indicating member 913 abuts against the positioning member 940.
After the assembly is completed, the indicator 913 is perpendicular to the side of the extension 912 and extends into the viewing window 990, and when the driving member 910 is radially pulled out from the guiding groove 970, the driving member 910 is restricted from being released from the handle 10 by the indicator 913 abutting against the viewing window 990, so that the driving member 910 is prevented from being released from the handle 10 during normal use. The upper and lower bottoms of the indicator 913 are fitted to the upper and lower planes of the observation window 990 in the longitudinal direction, thereby guiding the driving member 910.
As shown in FIGS. 43 and 44, in one embodiment, the inner needle cannula 43 is provided with a bend 46 after passing through the drive member 910, the bend 46 being located within the handle 10 and serving to release the sliding traction on both sides of the bend 46.
The proximal end of the inner needle tube 43 is connected to the external device through a tube, and therefore generally needs to be fixed to the proximal end of the handle, the bending section 46 is arranged to be circuitous in the handle 10, and when the inner needle tube 43 slides, the bending section 46 is correspondingly deformed to avoid that the fixation to the proximal end of the handle is affected when the inner needle tube 43 slides, namely, the sliding traction on two sides of the bending section 46 is released.
In one embodiment, the curved section 46 has a lower stiffness relative to the portion of the inner needle cannula 43 distal to the curved section 46.
The distal end of the bending section 46 is the sliding section 45, and the sliding section 45 is made of a material with high hardness or has a thick pipe wall, so that when the driving member 910 drives the sliding section 45 in a sliding manner, sufficient axial pushing force is maintained. The bending section 46 has a lower stiffness, i.e. is relatively more flexible, which ensures that the connection between the handle and the strain relief is avoided as far as possible for the purpose of maintaining the desired connection or sealing effect.
The working principle of the application is as follows:
an operator pinches the second operating portion 941 of the positioning member 940, radially pulls out the positioning member 940 to separate from the slot 950, slides the positioning member 940 to the corresponding slot 950 with a preset value along the hollow-out region 980, and then inserts the positioning member 940 into the corresponding slot 950 to complete the setting of the preset value.
The operator inserts the suction head 30 and the sheath 20 of the interventional instrument 100 into the human body, determines the puncture point of the tissue and organ, and then pushes the driving member 910 distally until the driving member abuts against the positioning member 940. During this period, the extension 912 of the driving member 910 pulls the inner needle tube 43 to slide distally and causes the inner needle tube 43 to penetrate the tissue organ, and at the same time, the bending section 46 of the inner needle tube 43 gradually straightens to match the sliding of the sliding section 45. After the puncture is completed, the driving member 910 is retracted, and the driving member 910 pulls the inner needle tube 43 to slide proximally and to withdraw the inner needle tube 43 from the tissue organ, and at the same time, the bending section 46 of the inner needle tube 43 bends to match the sliding of the sliding section 45.
When the positioning member 940 of the interventional instrument 100 is loosened or damaged, an operator pinches the second operating portion 941, rotates the second operating portion by 90 degrees, pulls out the positioning member 940, and directly replaces the positioning member 940.
In the interventional instrument capable of indicating the stroke, the positioning part 940 which abuts against the driving part 910 to limit the sliding of the driving part 910 is detachably connected with the clamping groove 950, so that the installation and the disassembly maintenance are convenient. And the driving member 910 does not need to be unlocked or an additional force for overcoming the attraction force is not required to be applied when the driving member 910 is pulled back, so that the whole sliding process of the driving member 910 is smoother.
Whether puncturing or injecting a medicament or contrast medium, etc., the sealing of the relevant moving parts is also an important aid, as shown in fig. 45-47, in which some embodiments further improve the manner of engagement between the inner needle tube 43 and the proximal portion of the outer needle tube 44, for example, in one embodiment, an interventional instrument 100 is also provided, the interventional instrument 100 further comprising an outer needle tube 44 disposed within the sheath 20, the distal end of the outer needle tube fixedly abutting or extendedly fixed within the operating channel 33, and the proximal end of the outer needle tube 44 extending and fixed to the handle 10; a driving member 921 is movably mounted on the handle 10, the inner needle tube 43 is slidably disposed in the outer needle tube 44, the proximal end of the inner needle tube 43 extends out of the outer needle tube 44 and is coupled with the driving member 921, and the radial gap between the inner needle tube 43 and the outer needle tube 44 is sealed. Of course, combinations of the foregoing and embodiments are also possible.
The distal and proximal ends of the outer needle cannula 44 are fixed to form a sliding guide path for the inner needle cannula 43 to slide. The driving member 921 is partially exposed from the handle 10 for operation by an operator. The part of the needle stick extends into the handle 10 and is fixed with the inner needle tube 43, and the operator pulls the inner needle tube 43 along the outer needle tube 44 by the driving piece 921 outside the handle 10 to complete the sliding puncture.
And after the vacuum is generated in the working cavity 31, the medium in the working cavity 31 is easy to reversely permeate into the handle 10 from the gap between the inner needle tube 43 and the outer needle tube 44, so that the radial gap between the inner needle tube 43 and the outer needle tube 44 in the handle 10 is sealed, and the medium is prevented from permeating into the handle 10. The sealing arrangement may be a direct filling of the gap, or an obstacle may be provided to block the end face of the outer needle tube 44 and to form a clearance fit with the inner needle tube 43 to block the gap and prevent the medium from penetrating.
In one embodiment, the handle 10 further has a mounting chamber disposed at the proximal end of the second bending chamber 13, the mounting chamber has a guiding sleeve 920 fixed therein, the proximal end of the outer needle tube 44 extends into the guiding sleeve 920 and is in sealing engagement with the inner wall of the guiding sleeve 920, a sealing member 930 for sealing the guiding sleeve 920 is fixed in the guiding sleeve 920, the proximal end of the inner needle tube 43 extends out of the outer needle tube 44 and then passes through the sealing member 930 and is connected to the driving member 910, and the inner needle tube 43 and the sealing member 930 are in sliding sealing engagement.
The distal and proximal ends of the outer needle cannula 44 are fixed to form a sliding guide path for the inner needle cannula 43 to slide. The driving member 921 is partially exposed from the handle 10 for operation by an operator. The part of the needle stick extends into the handle 10 and is fixed with the inner needle tube 43, and the operator pulls the inner needle tube 43 along the outer needle tube 44 by the driving piece 921 outside the handle 10 to complete the sliding puncture.
And after the vacuum is generated in the working cavity 31, the medium in the working cavity 31 is easy to reversely permeate into the handle 10 from the gap between the inner needle tube 43 and the outer needle tube 44, so that the radial gap between the inner needle tube 43 and the outer needle tube 44 in the handle 10 is sealed, and the medium is prevented from permeating into the handle 10. The sealing arrangement may be a direct filling of the gap, or an obstacle may be provided to block the end face of the outer needle tube 44 and to form a clearance fit with the inner needle tube 43 to block the gap and prevent the medium from penetrating.
Interventional instrument 100 in other embodiments further includes suction head 30, and sheath 20 connecting suction head 30 and handle 10, depending on the operational requirements of the distal end. The interventional device 100 has opposite distal and proximal ends, the distal end being on the side of the suction head 30 and the proximal end being on the side of the handle 10, the interventional device 100 further having an axial direction, the perpendicular axial direction being radial.
The handle 10 is in the form of a sleeve that can be held in one hand. The handle 10 is assembled from a first handle case 901 and a second handle case 902, and is convenient for assembling and fixing other parts such as the threading sleeve 920.
The threading sleeve 920 is a cylindrical structure for fixing the outer needle tube 44, and the threading sleeve 920 is disposed parallel to the axial direction of the interventional instrument 100 and fixed in the handle 10 by other connection methods such as gluing or inserting. The fit relationship between the guiding sleeve 920 and the outer needle tube 44 is a clearance fit.
The sealing member 930 is fixed inside the threading sleeve 920 by other connection methods such as gluing or inserting, and radially seals a part of the inner wall of the threading sleeve 920 to block the outer needle tube 44 from extending out of the threading sleeve 920. The fit clearance between the inner needle tube 43 and the sealing member 930 satisfies the dimensional requirements that the inner needle tube 43 can slide smoothly and liquid cannot penetrate. The liquid permeating between the inner needle tube 43 and the outer needle tube 44 is blocked, and the liquid is prevented from permeating into the handle 10 to influence the work of other parts.
As shown in fig. 45 to 47, the proximal end of the outer needle tube 44 is fixed to the insertion sheath 920, the distal end of the outer needle tube 44 is fixed to extend into the suction head 30, and a guide path is formed to urge the inner needle tube 43 to slide along the guide path after both ends are fixed.
As shown in fig. 48 and 49, in one embodiment, the inner diameter of the distal side of the passing sheath 920 gradually tapers to form a guide section 9202. The sealing fit between the outer needle tube 44 and the inner wall of the threading sleeve 920 is as follows: the outer wall of the outer needle cannula 44 is clearance fit with the inner wall of the mounting bore 9201 and the clearance acts as a glue groove and is adhesively secured and/or the proximal end of the outer needle cannula 44 is sealed against the sealing member 930.
The threading sleeve 920 is provided with a fixing hole 9201 through which the outer needle tube 44 is threaded along the self axial direction, and the far end of the fixing hole 9201 is provided with a guide section 9202. The guiding section 9202 is one of the inflection points of the outer needle tube 44, and the flaring design of the guiding section 9202 enables the outer needle tube 44 to be smoothly bent and transited at the inflection point, so that the inner needle tube 43 positioned in the outer needle tube 44 can be favorably slid.
The glue groove further comprises a gap between the inner wall of the guide section 9202 and the outer wall of the outer needle tube 44, and the glue filling amount is increased, so that the outer needle tube 44 used as the sliding guide of the inner needle tube 43 further strengthens the fixation with the threading sleeve 920.
The proximal side of the outer needle cannula 44 may extend into the interior of the sealing member 930 or may abut directly against the end surface of the sealing member 930, and the sealing member 930 may close the gap between the outer needle cannula 44 and the inner needle cannula 43 to prevent fluid from penetrating into the handle 10, thereby ensuring proper use of the device.
As shown in fig. 48 to 50, in one embodiment, a mounting opening 9203 is formed on a side wall of the threading sleeve 920, and the sealing member 930 is fixedly inserted into the threading sleeve 920 through the mounting opening 9203.
The sealing element 930 is radially inserted into the threading sleeve 920 through the mounting port 9203, the inner wall of the mounting port 9203 is in clearance fit with the outer edge of the sealing element 930, and the installation is convenient through simple plug fit.
In one embodiment, as shown in fig. 48 and 49, the sealing member 930 is a strip-shaped elastomer and is adhesively secured to the lead-through sheath 920.
The sealing member 930 is a cylindrical or other post-type structure. After the sealing member 930 is inserted into the threading sleeve 920, the gap between the sealing member and the threading sleeve 920 is circumferentially closed by the elasticity of the sealing member. During assembly, the outer circumference of the sealing member 930 is glued and cured after insertion into the threading sleeve 920, making the connection more secure. The sealing member 930 is prevented from moving during use, so that the friction force of the sealing member on the inner needle tube 43 is increased, and the operation damping feeling is increased.
The specific installation mode of the threading sleeve 920 and the sealing member 930 is as follows: as shown in fig. 50, in one embodiment, the inner wall of the threading sleeve 920 is provided with a first limiting groove 9204 opposite to the installation opening 9203, and one end of the sealing element 930 is fixed in the first limiting groove 9204, and the other end is fixed in the installation opening 9203.
In one embodiment, the sealing member 930 is provided with an avoiding hole 9301, and the inner needle tube 43 penetrates through the avoiding hole 9301 and is tightly fitted with the inner wall of the avoiding hole 9301.
The axial direction of the avoiding hole 9301 is parallel to the fixing hole 9201 of the threading sleeve 920, and after assembly, the avoiding hole 9301 is communicated with the fixing hole 9201, so that the inner needle tube 43 can smoothly pass through. The avoiding hole 9301 is tightly matched with the inner needle tube 43, and because the outer diameter of the inner needle tube 43 is smaller than the inner diameter of the outer needle tube 44, the inner diameter of the avoiding hole 9301 is smaller than the inner diameter of the fixing hole 9201, so that the proximal end face of the outer needle tube 44 abuts against the sealing element 930, the gap between the outer needle tube 44 and the inner needle tube 43 is sealed, and liquid is prevented from permeating into the handle 10.
Because the sealing element 930 is installed in the process of threading the sleeve 920, if there is no limit or other calibration method, the fixing hole 9201 and the avoiding hole 9301 will generate a certain eccentricity, and they will not correspond to each other seriously, so that the inner needle tube 43 and the outer needle tube 44 will deviate at the position where the avoiding hole 9301 abuts against the outer needle tube 44, the sliding friction force between the inner needle tube 43 and the outer needle tube 44 is increased, and the operation damping feeling is increased. The limiting groove 9204 is used for positioning the installation of the sealing element 930, and when the sealing element 930 abuts against the limiting groove 9204 during assembly, the assembly of the sealing element 930 is completed. Meanwhile, the avoiding hole 9301 corresponds to the fixing hole 9201, so that the eccentric amount of the inner needle tube 43 and the outer needle tube 44 is reduced, and the operation is convenient.
Another installation method of the threading sleeve 920 and the sealing member 930 is as follows: as shown in fig. 49, in one embodiment, the mounting opening 9203 is a through hole, and the sealing member 930 is fixed inside the mounting opening 9203.
The shape of the sealing element 930 is adapted to the mounting opening 9203, and when the sliding sleeve of the sealing element 930 is embedded into the mounting opening 9203, the concentricity of the avoiding hole 9301 and the fixing hole 9201 is calibrated by means of the mutual friction force. The mounting opening 9203 is a through hole, which facilitates the mounting and dismounting of the sealing member 930 from two sides.
In a preferred embodiment, in one embodiment, the lead-through sleeve 920 and the relief hole 9301 are concentric.
Specifically, the fixing hole 9201 of the threading sleeve 920 is concentric with the avoiding hole 9301, so that the eccentricity of the inner needle tube 43 and the outer needle tube 44 is reduced, and the sliding friction force of the inner needle tube 43 caused by the excessive eccentricity of the inner needle tube and the outer needle tube at the near end is avoided. Ensuring the smooth sliding of the inner needle tube 43.
In one embodiment, the sealing element 930 does not protrude beyond the mounting opening 9203 in the radial direction of the insertion sleeve 920.
When the threading sleeve 920 is assembled into the handle 10, interference caused by surface protrusions is avoided, thereby preventing the assembly from being affected.
As shown in fig. 51, in one embodiment, a second limiting groove 9002 is formed in the handle 10, and the threading sleeve 920 is fixed in the second limiting groove 9002.
The second stopper groove 9002 is provided in one or both of the first handle case 901 and the second handle case 902.
The inner wall of the second limiting groove 9002 is provided with an inner edge surface 9003 adapted to the outer peripheral surface of the threading sleeve 920, and a plane 9004 limiting the threading sleeve 920 from sliding to a far end in the axial direction. The inner edge surface 9003 is in clearance fit with the threading sleeve 920 to limit the radial movement of the threading sleeve 920, and the gap and/or the plane 9004 are/is coated with glue and embedded into the second limiting groove 9002 for fixation, so that the assembly is convenient.
As shown in FIG. 1, in one embodiment, the interventional instrument 100 further comprises a hub 600 disposed outside the proximal end of the handle 10, and the inner needle cannula 43 continues to extend out of the handle 10 via the drive member 910 and is connected to the hub 600.
Connector 600 is a medical luer connector, facilitating assembly and replacement. The luer fitting may be attached directly to the proximal end of the handle 10. Since the proximal end of the handle 10 is further provided with other pipes for connecting auxiliary devices (such as a washing device and an endoscope), in a preferred embodiment, the luer connector is sleeved and fixed at the proximal end of the handle 10 through the connecting pipe 610, so as to leave an assembly space for other devices, and the inner needle tube 43 is inserted into the connecting pipe 610, so that the inner needle tube 43 is protected by the connecting pipe 610.
The working principle of the application is as follows:
the interventional device 100 extends the absorption head 30 and the sheath 20 to the vicinity of a target point of a human body, when the absorption head 30 is absorbed on the target point, the driving member 910 is pushed to the far end, the driving member 910 pulls the inner needle tube 43 to slide to the far end along the arrangement path of the outer needle tube 44, the bending section 46 of the inner needle tube 43 is gradually straightened, the inner needle tube 43 in the absorption head 30 penetrates into the target point, and a series of surgical operations such as injection and the like are performed. After the above operations are completed, the driving member 910 is pulled back to the proximal end, the driving member 910 pulls the inner needle tube 43 to slide along the outer needle tube 44 to the proximal end, and exits the target point, meanwhile, the bending section 46 of the inner needle tube 43 is gradually bent, the operation suction head 30 is separated from the target point, and the operation suction head is moved to the next target point for operation.
In order to facilitate the switching of the injectant, as shown in fig. 52, some embodiments are further modified on the inner needle tube 43, for example, in one embodiment, an inner needle tube 43 applied to the interventional instrument 100 is further provided, the inner needle tube 43 comprises a first delivery tube 410 and a second delivery tube 420 nested inside and outside, wherein the first delivery tube 410 is located inside, and the distal end is in a spike structure, and the first delivery tube 410 is provided with an infusion port on the tube wall adjacent to the distal end. Of course, combinations of the foregoing and embodiments are also possible.
The second delivery tube 420 is outside and the distal seal surrounds the infusion port. The interior of the first delivery tube 410 serves as a first injection channel, the radial gap between the second delivery tube 420 and the first delivery tube 410 serves as a second injection channel, and the second injection channel communicates with the first injection channel via the infusion port.
For convenience of description, the first injection channel is used for inputting the first fluid, and the second injection channel is used for inputting the second fluid.
The first delivery pipe 410 is a hollow pipe member, and the inner wall forms a first injection passage for inputting the first fluid. The distal end of the first delivery tube 410 is a single-side V-shaped or double-side V-shaped sharp structure, which facilitates puncturing tissue and organs. Second delivery tube 420 first delivery channel 410 first delivery channel 450 second delivery channel 460 the distal end of the second delivery tube 420 is attached to the outer wall of the first delivery tube 410 at a connection point that forms a circumferential seal. The connection point is annular and between the tip structure and the infusion port such that the only outlet at the distal end of the second delivery channel 460 is the infusion port through which the second fluid input at the second delivery channel 460 can only flow into the first injection channel.
In the embodiment, the first conveying pipe 410 and the second conveying pipe 420 are integrated in an internal and external nesting mode, so that the parallel arrangement of a plurality of pipelines is avoided, different injection purposes can be realized by the same puncture action, on the basis, the arrangement mode and the specific position of the perfusion opening are correspondingly improved, and the operation residue in the previous time can be reduced.
In a preferred embodiment, the joint between the distal end of the second delivery tube 420 and the first delivery tube 410 has a smooth outer periphery, and the joint avoids scraping with the peripheral structure, thereby improving the smoothness of operation. As shown in FIGS. 53 and 54, in one embodiment, the inner needle tube 43 passes through the handle 10 from the distal end of the handle 10 and out of the proximal end of the handle 10, the proximal end of the inner needle tube 43 is connected to a tee 800 located outside the handle 10, and the first delivery tube 410 and the second delivery tube 420 are divided into two independent paths by the tee 800.
Tee 800 includes three connections in communication with each other, a first connection 810, a second connection 820, and a third connection 830 that communicates only with the second injection channel. The first delivery tube 410 and the second delivery tube 420 extend into the tee 800 via the first fitting 810, and the proximal end of the second delivery tube 420 is sealingly connected to the inner wall of the first fitting 810. First delivery tube 410 extends out of the proximal end of second delivery tube 420 and into second fitting 820, and second fitting 820 communicates only with the first injection channel.
The tee 800 provides a space for the delivery channel and tubing to be secured, with the first connector 810 opening proximally, the second connector 820 and the third connector 830 opening distally, with the proximal end being connected to the interventional instrument 100 by a thread or tubing, and the opposite distal end facilitating the connection of the tubing to avoid interference with the proximal interventional instrument 100. The channels in the second connector 820 and the third connector 830 are flowed through by the first fluid and the second fluid, respectively. The first connector 810 is coaxial with the third connector 830 to facilitate the delivery of the second fluid, and the second connector 820 is disposed at an acute angle to the third connector 830 to reduce the bending of the first delivery tube 410 to facilitate the delivery of the first fluid. The second delivery tube 420 extends into the first connector 810 only and is fixed to the inner wall of the first connector 810 by adhesive sealing, so as to close the gap between the inner needle tube 43 and the first connector 810 and prevent the second delivery tube from leaking out of the first connector 810. Second delivery tube 420 first delivery tube 410 second delivery tube 420 inner needle 43.
The first injection channel and the second injection channel are branched after extending out of the proximal end of the handle, and are connected with respective auxiliary equipment, and the three-way structure can be pre-formed, so that the assembly is convenient, and the pipeline butt joint is relatively simplified.
As shown in fig. 55 and 56, in one embodiment, the opening 840 of the second connector 820 is sealingly engaged with an adapter tube, and the first delivery tube 410 is sealingly engaged with the adapter tube.
The diameter of the first delivery pipe 410 is small, and if the inner wall of the second connector 820 is matched with the first delivery pipe, and the two are fixed to each other, the gap between the second connector 820 and the first delivery pipe 410 is difficult to fill with glue, and the sealing performance is not enough. The second connector 820 may also be used to connect an accessory device (e.g., a medication delivery device) via threads or the like, which may be difficult to manufacture due to the small overall size. The second connector 820 is thus connected to the auxiliary device via an adapter.
The adapter tube is provided with boss 510 with opening position 840 matched with to and the through-hole 520 that suits with first conveyer pipe 410, the cooperation of boss 510 and opening position 840 makes adapter tube and second joint 820 slide each other, during the installation, at through-hole 520 inner wall and the rubber coating of first conveyer pipe 410 outer wall, first conveyer pipe 410 wears to establish behind through-hole 520, treat the glue solidification, both reciprocal anchorage, the clearance between first conveyer pipe 410 and the through-hole 520 inner wall is effectively filled up to glue, avoid the fluid to ooze. The far end of the adapter tube is also provided with a thread connected with auxiliary equipment.
As shown in fig. 57 and 58, in one embodiment, the inner cavity of the second connector 820 is formed with a rubber groove in the opening portion 840 in a diameter-expanding manner, and one end of the adapter tube is inserted and fixed in the rubber groove by gluing.
The second joint 820 and the adapter tube can be fixed in an adhesive manner, and the second joint 820 forms an adhesive groove in an expanding manner to ensure a sufficient radial gap, so that a sufficient amount of adhesive can be accommodated, and the problem of uneven adhesive distribution due to too small gap is avoided.
As shown in fig. 56 to 58, in one embodiment, the outer circumference of the adapter tube has an annular step 530, and the open end surface 850 of the second connector 820 abuts against the annular step 530 to close the glue groove.
The annular step 530 may be a hard seal with the open end surface 850, but may be sealed by an O-ring to prevent the second fluid from leaking out of the second connector 820 due to the presence of an undercoating or a missing coating in the glue groove.
The provision of the annular step 530 not only increases the sealing contact area and enhances the adhesive sealing effect, but also allows for adaptability to the outer diameters of both the adapter tube and the second connector 820.
As shown in fig. 59, in one embodiment, the second connector 820 and the third connector 830 are directly or indirectly provided with an adapting structure 860 for connecting external pipelines.
The joint and the external pipeline can be connected through threads or mutually matched plug and socket structures. For example, the inner unsealed fixed conduit of the third fitting 830 could be directly externally threaded, and have a sealing surface with a sealing score line. The second fitting 820 adhesively secures the transition tube 500. the transition tube 500 is externally threaded and has a sealing surface with a sealing score line. Correspondingly, the external pipeline is provided with matched internal threads and a sealing surface with a sealing reticle, so that the connection between the joint and the external pipeline is completed, and the leakage is effectively prevented.
As shown in FIG. 60, in one embodiment, the distal end of the first delivery tube 410 is butted with a metal tubular needlepoint 430, the tubular needlepoint 430 provides a spike structure, and the perfusion opening is opened at the side wall of the tubular needlepoint 430.
The needle tip 430 is inserted or sleeved with the distal end of the first transmission pipe 410 and fixed in a heat-shrinkable manner. And the needle tip 430 is made of metal material with certain strength, so that the wear resistance of the needle tip 430 is improved, and the puncture times are increased. The pouring port is opened as close to the needle tip 430 as possible but does not communicate with the needle port 440, and the pouring port is a communication switching port, and the closer to the needle port 440 the pouring port is, the less the amount of residue remains in the previous operation when switching the injection.
In one embodiment, an injection system employing the above described interventional instrument 100 is disclosed, comprising a hydrogel delivery device in communication with a first injection channel in the interventional instrument 100, and a contrast delivery device in communication with a second injection channel in the interventional instrument 100.
The contrast agent delivery device is connected with the third connector 830 through a pipeline, and the hydrogel delivery device is connected with the second connector 820. After the interventional instrument 100 is punctured into the target, the contrast agent delivery device is started, the contrast agent flows through the perfusion opening through the second delivery pipe 420 and enters the first delivery pipe 410, the contrast agent is output from the needle opening 440, the blood vessel distribution and the blood flow condition are enhanced and displayed, after the target is proper, the hydrogel delivery device is opened, and the hydrogel is output into the target through the first delivery pipe 410, so that the injection is completed. The positioning and injection operation can be completed without replacing the puncture needle.
The interventional instrument 100 of the present application is provided with a first delivery tube 410 and a second delivery tube 420 in parallel, and infusion ports provided in the wall of the first delivery tube 410 to accomplish the injection of different drugs or biological materials into the same puncture site. The complicated steps of replacing the puncture needle are omitted.
The technical features of the above embodiments can be arbitrarily combined, and for the sake of brevity, all possible combinations of the technical features in the above embodiments are not described, but should be considered as the scope of the present specification as long as there is no contradiction between the combinations of the technical features. When technical features in different embodiments are represented in the same drawing, it can be seen that the drawing also discloses a combination of the embodiments concerned.
The above examples only express several embodiments of the present application, and the description thereof is more specific and detailed, but not construed as limiting the claims. It should be noted that, for a person skilled in the art, several variations and modifications can be made without departing from the concept of the present application, which falls within the scope of protection of the present application.

Claims (21)

1. The interventional instrument is characterized by comprising a sheath, a handle connected to the proximal end of the sheath and an adsorption head connected to the distal end of the sheath;
the adsorption head is provided with a working cavity, an adsorption port which is communicated with the working cavity and is used for acting with an adsorbed object, and an adsorption channel and an operation channel which are respectively communicated with the working cavity;
an inner needle tube which can extend out of or retract into the adsorption port through the operation channel is arranged in the sheath tube in a sliding mode, a plurality of traction wires are arranged in the sheath tube, one end of each traction wire is fixed to the far-end part of the sheath tube, the other end of each traction wire extends to the handle, and the handle can drive each traction wire;
the traction wires comprise a first traction wire, a second traction wire and a third traction wire, and the third traction wire is driven by the handle to pull the adsorption head to move towards one side where the adsorption port is located;
the handle is internally provided with a first bending adjusting chamber and a second bending adjusting chamber, a driving disc is rotatably arranged in the first bending adjusting chamber, the proximal ends of the first traction wire and the second traction wire are connected with the driving disc, and the driving disc drives the first traction wire and the second traction wire to synchronously and reversely move when rotating;
the handle comprises a support body and a rotating handle rotatably arranged on the periphery of the support body, a second bending adjusting chamber is defined between the support body and the rotating handle, a linkage piece in threaded fit with the rotating handle is slidably arranged on the support body, and the near end of the third traction wire is connected with the linkage piece and used for drawing the adsorption head to move towards one side where the adsorption port is located;
the rotation axis of the driving disk is perpendicular or oblique to the axis of the rotating handle.
2. The interventional instrument of claim 1, wherein the working lumen is arranged in a manner that:
a body cavity, or
Include a plurality of sub-chambeies at the inside mutual intercommunication of adsorption head, adsorb passageway and operation passageway respectively with the sub-chamber intercommunication that corresponds, the absorption mouth communicates at least the sub-chamber at operation passageway place.
3. The interventional instrument of claim 2, wherein the working chamber is a body cavity, the communication portion of the operation channel and the working chamber is a first communication port, the communication portion of the suction channel and the working chamber is a second communication port, the first and second communication ports are both located on a proximal end side of an inner wall of the working chamber, and the second communication port is located closer to the suction port than the first communication port.
4. The interventional instrument as claimed in claim 1, wherein the proximal end side of the suction head is further provided with an endoscope channel and a cleaning channel respectively communicating with the working chamber;
in the adsorption channel, the operation channel, the endoscope channel and the cleaning channel, the channels are mutually independent or at least the two channels are closed and communicated, and the channels are respectively formed in the following modes:
a channel is formed by opening a hole on the adsorption head, the far end of the hole is communicated with the working cavity, and the near end of the hole is opened to be in butt joint with an external pipeline;
or a pipeline is arranged in the opening in a penetrating way, the far end of the pipeline is communicated with the working cavity, and the near end of the pipeline extends out of the adsorption head.
5. The interventional instrument of claim 4, wherein the periphery of the suction port is provided with a sealing lip protruding for abutting against the adsorbate.
6. The interventional instrument of claim 5, wherein the sealing lip is annular with a flared edge.
7. The interventional instrument as claimed in claim 4, wherein the opening portion of the suction port is a communication region or is divided into a plurality of unit regions; the plurality of unit regions are formed in a regularly distributed grid structure or a random porous structure.
8. The interventional instrument of claim 1, wherein a rotating member is mounted within the handle, wherein the bending directions of the two pull wires are opposite, and wherein the two pull wires are connected to the rotating member in opposite winding directions.
9. The interventional instrument of claim 8, wherein the rotating member is disc-shaped and has an axis of rotation perpendicular to a plane in which the suction port is located.
10. The interventional instrument of claim 1, wherein at least a portion of the first traction wire and the second traction wire is wrapped around an outer periphery of the drive disk or within a wire slot in an axial disk surface of the drive disk.
11. The interventional instrument of claim 1, wherein the first pull wire and the second pull wire are diametrically opposed along the sheath, the third pull wire is circumferentially between the first pull wire and the second pull wire along the sheath, and the suction port is oriented in accordance with a circumferential position of the third pull wire relative to the sheath.
12. The interventional instrument of claim 1, wherein the handle defines an operating slot in communication with the first bending chamber; the periphery of the driving disc is provided with a driving handle, and the driving handle extends out of the first bending adjusting chamber from the operating slot.
13. The interventional instrument of claim 1, wherein the outer periphery of the linkage member has external threads and the inner wall of the rotation knob has internal threads that mate with the external threads.
14. The interventional instrument of claim 1, wherein the handle further comprises a locking mechanism that locks or releases the drive disk, the locking mechanism continuously defining the angle of rotation of the drive disk or defining the angle of rotation of the drive disk from gear to gear.
15. The interventional instrument of claim 14, wherein the locking mechanism comprises:
and the knob is in threaded fit with the handle, at least one part of the knob is exposed outside the handle, and in the rotating process of the knob, the knob is far away from or presses against the driving disc, and the driving disc is locked in a pressed state.
16. The interventional instrument of claim 14, wherein the locking mechanism comprises:
a plurality of locking grooves arranged on the driving disc along the circumferential direction of the driving disc;
the positioning piece is movably installed in the first bending adjusting chamber, and in the rotating process of the driving disc, the positioning piece is clamped with the corresponding locking groove.
17. The interventional instrument of claim 16, wherein the locking mechanism further comprises: and the elastic driving piece is abutted to the positioning piece so as to drive the positioning piece to be kept clamped with the corresponding locking groove.
18. The interventional device of claim 1, further comprising an outer needle cannula within the sheath, a distal end of the outer needle cannula being fixedly docked with or extendedly secured within the operative channel, a proximal end of the outer needle cannula extending and secured to the handle;
the handle is movably provided with a driving piece, the inner needle tube is arranged in the outer needle tube in a penetrating mode in a sliding mode, the near end of the inner needle tube extends out of the outer needle tube and is linked with the driving piece, and the inner needle tube and the outer needle tube are arranged in a sealing mode in the radial gap.
19. The interventional instrument as claimed in claim 18, wherein the handle further comprises a mounting chamber disposed at a proximal end of the second bending chamber, a penetrating sleeve is fixed in the mounting chamber, a proximal end of the outer needle tube extends into the penetrating sleeve and is fixedly and sealingly engaged with an inner wall of the penetrating sleeve, a proximal end of the inner needle tube extends out of the outer needle tube and the penetrating sleeve in sequence and is connected to the driving member, and the inner needle tube is slidably and sealingly engaged with an inner wall of the penetrating sleeve.
20. The interventional instrument of claim 1, wherein the inner needle cannula comprises first and second delivery tubes nested inside and outside, wherein:
the first conveying pipe is positioned at the inner side, the far end of the first conveying pipe is of a spine structure, and a perfusion opening is formed in the pipe wall of the first conveying pipe, which is adjacent to the far end;
the second delivery pipe is positioned at the outer side, and the distal end of the second delivery pipe hermetically surrounds the perfusion opening;
the inside of the first conveying pipe is used as a first injection channel, the radial gap between the second conveying pipe and the first conveying pipe is used as a second injection channel, and the second injection channel is communicated with the first injection channel through the perfusion opening.
21. The interventional instrument as claimed in claim 20, wherein the inner needle tube penetrates into the handle from the distal end of the handle and penetrates out from the proximal end of the handle, the proximal end of the inner needle tube is connected to a tee located outside the handle, and the first delivery tube and the second delivery tube are separated into two independent tubes through the tee.
CN202010947369.9A 2020-09-10 2020-09-10 Interventional instrument Active CN112244950B (en)

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CN114145787B (en) * 2021-12-01 2023-11-17 上海傲流医疗科技有限公司 Multi-stay rope control handle of interventional device
WO2023125400A1 (en) * 2021-12-31 2023-07-06 深圳市健心医疗科技有限公司 Bending-adjustable sheath
CN115227183B (en) * 2022-08-30 2023-05-16 湖南省华芯医疗器械有限公司 Traction wheel, traction rope adjusting mechanism, operating handle and endoscope
CN115919431B (en) * 2023-03-09 2023-06-09 上海微创电生理医疗科技股份有限公司 Atrial septum puncture device

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GB0816262D0 (en) * 2008-09-05 2008-10-15 Univ Cardiff Surgical manipulator
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