CN101390770B - Puncture body disposable adherent observation type puncture endoscope for percutaneous renal stone-extraction operation - Google Patents
Puncture body disposable adherent observation type puncture endoscope for percutaneous renal stone-extraction operation Download PDFInfo
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- CN101390770B CN101390770B CN2008102316677A CN200810231667A CN101390770B CN 101390770 B CN101390770 B CN 101390770B CN 2008102316677 A CN2008102316677 A CN 2008102316677A CN 200810231667 A CN200810231667 A CN 200810231667A CN 101390770 B CN101390770 B CN 101390770B
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Abstract
The invention relates to a disposable puncture endoscope used for attached observation of a puncture body in percutaneous nephrolithotomy, solving the clinical restrictions of poor puncture accuracy, big amount of bleeding, high operation failure rate and poor safety of the existing appliances used in percutaneous nephrolithotomy. The puncture endoscope comprises an ocular unit, an image transferring unit, a main endoscope body, a lighting unit and a puncture body. The puncture body is composed of a disposable puncture needle and an indwelling catheter. The disposable puncture needle comprises a hollow outer tube and a plastic needle body. The ocular unit is composed of an ocular cover, and an ocular glass and an ocular lens which are arranged inside the ocular cover. The image transferring unit is composed of a multi-filament image transferring rod arranged inside the hollow outer tube of the puncture needle. The front end of the main endoscope body is connected with the plastic needle body of the puncture needle and the back end of the main endoscope body is connected with the ocular cover of the ocular unit. The lighting unit is composed of a built-in lighting component and a detachable lighting component. The puncture endoscope has the advantages that the puncture endoscope is good in visibility during operations, high in puncture accuracy, less in bleeding, high in operation success ratio and high in safety and is unnecessary to be charged with water.
Description
Technical field
The present invention relates to a kind of medical surgical operation and use endoscope, relate in particular to a kind of percutaneous nephrolithotomy puncture endoscope.
Background technology
Percutaneous nephrolithotomy is a kind of new technique for the treatment of urinary system calculus that rises in recent years, and it utilizes special endoscope and intracavity rubble, get stone equipment finishes treatment by percutaneous kidney fistulation.Just there is the tradition of getting renal calculus through the skin puncture in Arab as far back as 10th century of Christian era, but success rate is lower due to limited conditions, fails to apply always.After mid-term 1970's, PCN came out, this technology was just fairly perfect, is applied.China then initial stage 1980's from this technology and equipment of external introduction, at first achieve success on Beijing, Guangzhou and other places, then push the whole nation to, domestic most big-and-middle-sized hospital has all carried out this operation at present, but the equipment that percutaneous nephrolithotomy needs is comparatively expensive, and specification requirement is also than higher.Also can carry out external stone crushing in the place that the external stone crushing condition is arranged and add the method that auxiliary lithagogue is treated, but the calculus time is long, and not necessarily thorough, effect can not be got instant result, therefore at present not as main Therapeutic Method.
Percutaneous nephrolithotomy generally is to need to carry out under the anesthesia, renal pelvis at first punctures under X line or ultrasonic guidance, but consider equipment manufacturing cost and to patient and doctor's radiation injury, the doctor is reluctant to adopt the mode of X line more, then puncture channel is expanded to and needs size, put into PCN through this passage, spy on down the calculus taking-up or calculus is smashed the back and take out with special rock crushing plant.
When operation is carried out, the first step: under cystoscopic guiding, particularly to the inapparent patient of hydronephrosis, soft conduit per urethra with F5, bladder, again through ureter, deliver to renal pelvis, so that in puncture, can fetch water to renal pelvis from the outside, such first can help developing under the B ultrasonic, second can be in puncture presses to renal pelvis and fetches water whether observe puncture tube fluid situation correct to judge that puncture arrives the position by adding, and the 3rd is to squeeze into liquid continuously after puncturing successfully, prevents the renal pelvis wound clot that condenses, the 4th is to form hydrops hollow in the renal pelvis, is beneficial to the use of PCN.Second step was operation success or failure keys: set up the passage from skin to the renal pelvis, it is fistulation, generally under B ultrasonic or X-ray machine guiding, carry out the kidney puncture fistula-building, one in puncture needle overcoat is put and is stayed pipe during puncture, the about 1.7mm of external diameter, puncture to renal pelvis, behind the renal calices, extract puncture needle out, put stay pipe to put to stay in through skin to renal pelvis, between renal calices, stay pipe slowly to be lowered to renal pelvis by putting on one soft rustless steel steel wire, in between renal calices and coil two or three circles, extract out to put then and stay pipe, put and stay steel wire, use diameter more than three kinds at last, the tapered convergent divergent channel of head is enclosed within to put and stays on the steel wire, has passage from thin to slightly expanding repeatedly, need diameter up to being expanded to, promptly finished the fistulation process.Puncture fistula-building generally carries out also can shifting to an earlier date puncture fistula-building at lithotomy simultaneously, when shifting to an earlier date puncture fistula-building, treats to carry out percutaneous nephrolithotomy again after sinus tract forms, and sinus tract forms common needs about 2 weeks.The advantage of carrying out is to perform the operation once to finish simultaneously, and the hospital stays is short; Shortcoming is to increase the chance of failure because of the hemorrhage cause influence operation technique that waits.In advance fistulation again the shortcoming of second operation be that the hospital stays is long, need the two operations operation, but sinus tract forms that afterwards intraoperative hemorrhage is less, gets a clear view the success rate of operation height.The 3rd step: use PCN by the fistulation passage, under line-of-sighting observation, carry out the searching and the taking-up of renal pelvis, renal calices and ureter epimere calculus or smash the back taking out, and finish operation.
Percutaneous nephrolithotomy just can be treated kidney and ureter epimere calculus by diameter less than 1 centimetre passage, than the operative treatment of routine little to patient trauma, strike is little, post-operative recovery is fast, and can repeat to treat residual through stone by the kidney fistulation pipe of keeping somewhere, advantage is conspicuous.
But this lithotomy also exists following two kinds of adverse factors and restricts its utilization in clinical:
The first, because the blood vessel in the kidney is the dendroid distribution, use the F5 fine needle aspiration progressively to expand the purpose of opening again during fistulation and be to avoid blood vessel, enter from the vascular branch gap, when expansion, can arrange blood vessel like this, hemorrhage during fistulation will be less, but can not judge whether to have pushed open blood vessel when having lithotomy now and still wear out blood vessel owing to puncture, the probability that causes not wearing out blood vessel is very low, often run into hemorrhage in the art, and hemorrhage sometimes can not at once the discovery, may outside renal tissue, form hematocele, certain risk is arranged, and directly have influence on the success or failure of operation.
The second, the image of B ultrasonic supervision is a plane picture, the third dimension of no depth direction, can not substantive solve puncture whether over against the problem of renal calices or renal pelvis, because once low piercing process that can cause in the operation of successful probability is often wanted repeated multiple times, generally promptly regard as and pierce into into renal calices or renal pelvis can discharge limpid liquid in the puncture needle of hollow.Solid is judged standard when puncturing under the X line, puncture accuracy height, but patient and doctor can accept a certain amount of radiation exposure inevitably, and can cause certain excess of the kidney matter damage, shortcoming is obvious.
If can design a kind of visual and can carry out the endoscope of bearing directing in puncture by electromagnetism or ultrasonic principle, just two restriction point of this operation clinical application of above-mentioned restriction can be readily solved.
But, four significant components of classical endoscope should comprise object lens, biography is as the unit, lighting unit and eyepiece, clinical practice based on this operation, if use the design concept of classical endoscope, then need an object distance, if before puncture needle, arrange a big unobstructed space, then can't satisfy the tiny more constraints that is difficult for injured blood vessel more, if in tiny puncture needle, arrange certain object distance, then pin hole place (visual place) will account for ultrafine part in the visual field, the interior pipe that the overwhelming majority around the visual field can be punctured pin occupies, but if puncture tube is processed into transparent material, present stage does not have to satisfy and can puncture, and rigidity and brittleness are again so good plastic materials.Like this, narrow and small impression can be given in the visual field of observing, simultaneously, the sealing of the transparent material that before needle tubing, carries out, no matter transparent material is installed and is processed into which kind of angle, all can't thoroughly eliminate the flare that brings by lighting source, thereby the definition of image can reduce significantly, therefore, puncture needle tiny determined to form the observation interval (as modes such as method by bath, qi of chong channel ascending adversely, mechanical expansion and transparent material sealings) of a hollow.
Technology on the multifilament image transmission optical fibre makes us might realize the visual of perforator, but its difficult point is that the head of ultra-fine sight glass can be finished puncture can carry out the structurally difficult realization of clear observation again, and the visual field also is subject to certain restrictions; Simultaneously, because piercing process is hemorrhage, if introduce flushing function, then water flushing channel can increase again the space requirement of puncture instrument at diametrically, also can increase technical difficulty, therefore will consider the visual difficult problem under not washing by water.
Summary of the invention
Be the puncture poor accuracy that solves institute's use apparatus in the existing percutaneous nephrolithotomy, hemorrhage many, the operative failure rate is higher, safety is relatively poor clinical restriction problem, the invention provides a kind of perform the operation visual good, the puncture accuracy is good, go out insufficiency of blood, success rate of operation is higher, safe, the disposable use attaching observation type puncture endoscope of percutaneous nephrolithotomy usefulness puncture body that need not to wash by water.
Technical solution of the present invention is:
A kind of percutaneous nephrolithotomy comprises ocular unit, passes as unit, main mirror 8 and lighting unit with the disposable use attaching observation type puncture endoscope of puncture body; Its special character is: it also comprises puncture body, and described puncture body comprises disposable puncture needle 15 and puts and stay pipe 13; The leading section of described puncture needle 15 is the spininess on band inclined-plane; Described puncture needle 15 comprises hollow outer pipe 14, plastics needle body 24; Described ocular unit comprises eyepiece hood 2, is arranged on eyepiece glass 1 and eyepiece camera lens 3 in the eyepiece hood 2; Described biography comprises that as the unit multifilament in the hollow outer pipe 14 that is arranged on puncture needle 15 pass picture rod 9, and the imaging surface 28 that described multifilament passes picture rod 9 constitutes solid spine for the inclined-plane and with the leading section of hollow outer pipe 14, and it goes out image planes 5 and is connected with ocular unit; The front end of described main mirror 8 is connected with the plastics needle body 24 of puncture needle 15, and its rear end is connected with the eyepiece hood 2 of ocular unit; Described lighting unit comprises internal illumination parts and detachable illuminace component; Described internal illumination parts comprise the light beam chuck 19 that can be connected with main mirror 8, be arranged on the light beam chuck 19 and the light beam interface 17 that can be connected with external light source, be arranged on light cone 18 in the light beam interface 17, be arranged on the interior biography light fibre bundle 10 of light beam interface 17; Described detachable illuminace component comprises the built-in fiber bundle 16 that is arranged in the puncture needle 15; Described biography light fibre bundle 10 and 16 butt joints of built-in fiber bundle; The front end of described built-in fiber bundle 16 with crescent shape be distributed in multifilament pass picture rod 9 around, the front end of described built-in fiber bundle 16 constitutes one and passes the suitable inclined-plane of imaging surface 28 of picture excellent 9 with multifilament.
It is short that the front end of above-mentioned built-in fiber bundle 16 passes picture rod 9 than multifilament; A circle that passes as rod 9 near multifilament on the inclined-plane that the front end of described built-in fiber bundle 16 constitutes scribbles transparent epoxy glue 27, and remainder is filled with black epoxy glue 26.
The solid spine that above-mentioned multifilament passes as the end formation of the imaging surface 28 of rod 9 and hollow outer pipe 14 comprises the forward puncture face 41 that is arranged on the spine forefront and the face 42 that punctures dorsad, be arranged on the auxiliary puncture face 43 at forward puncture face 41 rears, be separately positioned on the side direction puncture face 44 of forward puncture face 41 left and right sides, the scope of the puncture angle α of described forward puncture face 41 is: 14 °～19 °, the scope of the angle β that punctures dorsad of the described face 42 that punctures dorsad is: 26 °～5 °, the scope of the auxiliary puncture angle γ of described auxiliary puncture face 43 is: 40 °～10 °, the side direction puncture angle δ 1 of described side direction puncture face 44 and the scope of δ 2 are: 14 °～19 °, and the lateral deflection angle of described side direction puncture face 44
With
Scope be: 60 °～10 °.
Above-mentioned puncture endoscope also comprises azimuth sounder 20, described azimuth sounder 20 is ultrasonic detector, signal of telecommunication detector or magnetic signal detector, and it comprises signal transmitter unit, signal receiving unit 22 and signal processing unit 21 and be arranged on main mirror 8 excircles and is used for insulating base cover 11.
Above-mentioned signal transmitter unit is external signal transmitter unit 25; Described external signal transmitter unit 25, signal receiving unit 22 and signal processing unit 21 all are arranged on the outside of base cover 11.
The front end of above-mentioned main mirror 8 is connected with the plastics needle body 24 of puncture needle 15 by locking cap 12, and its rear end is connected with the eyepiece hood 2 of ocular unit by coupling sleeve 6.
Above-mentioned signal transmitter unit is a built-in signal transmitter unit 23; Described built-in signal transmitter unit 23 is placed in the human body, and described signal receiving unit 22 and signal processing unit 21 are arranged on the outside of base cover 11.
The front end of above-mentioned main mirror 8 is connected with the plastics needle body 24 of puncture needle 15 by locking cap 12, and its rear end is connected with the eyepiece hood 2 of ocular unit by coupling sleeve 6.
Above-mentioned puncture endoscope also comprises azimuth sounder 20, described azimuth sounder 20 is ultrasonic detector, signal of telecommunication detector or magnetic signal detector, and it comprises signal transmitter unit, signal receiving unit 22 and signal processing unit 21 and be arranged on main mirror 8 excircles and is used for insulating base cover 11.
The front end of above-mentioned main mirror 8 is connected with the plastics needle body 24 of puncture needle 15 by locking cap 12, and its rear end is connected with the eyepiece hood 2 of ocular unit by coupling sleeve 6.
The invention has the advantages that:
1, the present invention is provided with the biography of endoscope as unit and lighting unit in the puncture needle of operation puncturing fistulation, realized in operation the purpose of Real Time Observation while puncturing, simultaneously can judge accurately in piercing process whether position that puncture needle arrives exists blood vessel, thereby can avoid the blood vessel in the kidney effectively, avoid wearing out blood vessel in the operation and cause the hemorrhage situation of unexpected unexpected volume, reduced the blind potential risk that exists in the operation process of wearing; Have insufficiency of blood, higher, the safe advantage of success rate of operation.
2, the present invention installs one and has the azimuth sounder that ultrasonic, electric or magnetic is surveyed on the mirror body of endoscope, and the measuring basis axis of detector overlaps with puncture needle.Utilizing in the operation needs to renal pelvis, renal calices is introduced the process that a tubule is fetched water, to reload signal on the tubule (sound source or electromagnetic wave) transmitter unit, or directly utilize renal pelvis, the small water balloon that forms after renal calices is fetched water, or utilize renal pelvis, the ultrasonic echo characteristic of calyceal calculi, when puncture, do not point to renal pelvis, during renal calices, azimuth sounder can be measured renal pelvis, the orientation of renal calices and actual measurement datum axis (puncture needle sensing) angle spatially, just on X and Y direction, be offset screen center at simulation luminous point on the display device, offset distance is directly proportional with the drift angle, Shou Shu operator can adjust the direction of puncture endoscope according to screen display like this, make the simulation luminous point near screen center, thereby be back on the correct puncture direction.Because azimuth sounder has been installed, whether the puncture direction just in time pointed to renal calices or renal pelvis when the present invention can solve puncture fistula-building, in conjunction with above-mentioned first point, two important restrictive factors of influence operation success or failure when this instrument can solve traditional fistulation effectively, feasible puncture can disposablely put in place, reduces repeatability.
3, the present invention is provided with the biography of endoscope as unit and lighting unit in the puncture needle of operation puncturing fistulation, but and be designed to mechanism's (locking cap and coupling sleeve) that Fast Installation is changed, realized the disposable use of puncture needle, avoid may problem, the problem includes: the cross infection problem.
The imaging surface that multifilament passed as rod when 4, the present invention punctured well contacts owing to the existence of puncture force with tissue, can push effectively Real Time Observation to tissue surface (what promptly puncture caused organizes cleaved facet), squeeze blood and slime and hemostasis by compression, thereby cleared up the blood of sightingpiston, solved the visual difficult problem of the hemorrhage pollution in visual field under the situation of not washing by water.
5, the present invention punctures effective.After multifilament of the present invention passes the excellent imaging surface of picture and treats that tissues observed well contacts, no matter whether imaging surface passes vertical as excellent axis with multifilament, no matter whether imaging surface is polished to optical mirror plane, as long as satisfy good contact, just can imaging, therefore, the present invention can pass an end multifilament of puncture and be processed into the inclined-plane as rod, form puncture angle α, as shown in Figure 4, this profile has just in time kept consistent well with present puncture needle profile (forming sharp-pointed puncturing head thereby a hollow stainless steel tube is worn into the inclined-plane), the angle β that punctures is dorsad in addition making puncture break the edge that just in time is in the visual field into interlacing point, the blind area that the interlacing point of avoiding puncturing brokenly is not in the visual field occurs, and the side direction puncture angle δ 1 and the δ 2 of auxiliary puncture angle γ and left and right directions make endoscope obtain sharper puncture ability.
6, good illumination effect of the present invention does not influence the veiling glare of observing effect.The present invention adopts special lighting system, the light component that has guaranteed the directive visual field can evenly enter and pass multifilament and pass as each monofilament in the rod with illumination field of view, remainder is fixed with opaque black epoxy glue and hollow outer pipe, thereby the zone of avoiding not needing to observe also is illuminated the veiling glare that exerts an influence and observe.
Description of drawings
Fig. 1 is the structural representation of puncture endoscope of the present invention;
Fig. 2 is the profile sketch map of puncture endoscope of the present invention;
Fig. 3 is the STRUCTURE DECOMPOSITION sketch map of puncture endoscope of the present invention;
Fig. 4 is the end profiles sketch map of puncture needle of the present invention;
Fig. 5 is the structural representation of the leading section of the built-in fiber of puncture needle of the present invention;
Wherein: 1-eyepiece glass; 2-eyepiece hood; 3-eyepiece camera lens; 4-cover plate; 5-go out image planes; 6-coupling sleeve, 7-as excellent chuck; 8-main mirror; 9-multifilament passes the picture rod; 10-biography light fibre bundle; 11-base cover; 12-locking cap, 13-put and stay pipe; 14-hollow outer pipe; 15-puncture needle; 16-built-in fiber bundle; 17-light beam interface; 18-light cone; 19-light beam chuck; 20-azimuth sounder; 21-signal processing unit; 22-signal receiving unit; 23-built-in signal transmitter unit; 24-plastics needle body; 25-external signal transmitter unit; 26-black epoxy glue; 27-transparent epoxy glue; 28-imaging surface; 41-forward puncture face; 42-dorsad faces that puncture; 43-auxiliary puncture face; 44-side direction puncture face.
The specific embodiment
As Fig. 1, Fig. 2 and shown in Figure 3, percutaneous nephrolithotomy comprises that with the disposable use attaching observation type puncture endoscope of puncture body main mirror 8, puncture body, biography are as unit, lighting unit and ocular unit; Puncture body comprises disposable puncture needle 15 and puts and stay pipe 13; The leading section of puncture needle 15 is the spininess on band inclined-plane, and it comprises hollow outer pipe 14, plastics needle body 24; Ocular unit comprises eyepiece hood 2, is arranged on eyepiece glass 1 and eyepiece camera lens 3 in the eyepiece hood 2, and eyepiece hood can partly be realized combination fast and separate with camera detector and optical coupled, so that the autoclave sterilization of endoscope's mirror body portion; Biography comprises that as the unit multifilament in the hollow outer pipe 14 that is arranged on puncture needle 15 passes picture rod 9, the imaging surface 28 that multifilament passes picture rod 9 constitutes solid spine for the inclined-plane and with the leading section of hollow outer pipe 14, the multifilament biography goes out image planes one end by fixing as excellent chuck 7 as rod 9, uses image planes 5 and is connected with ocular unit; Lighting unit comprises internal illumination parts and detachable illuminace component; The internal illumination parts comprise the light beam chuck 19 that can be connected with main mirror 8, be arranged on the light beam chuck 19 and the light beam interface 17 that can be connected with external light source, be arranged on light cone 18 in the light beam interface 17, be arranged on the interior biography light fibre bundle 10 of light beam interface 17; Detachable illuminace component comprises the built-in fiber bundle 16 that is arranged in the puncture needle 15; Pass light fibre bundle 10 and 16 butt joints of built-in fiber bundle; The front end of built-in fiber bundle 16 is distributed in the multifilament biography as around the rod 9 than multifilament biography picture rod 9 weak points and with crescent shape, and inclined-plane that the front end of built-in fiber bundle 16 constitutes and multifilament biography keep approximately identical oblique angle as excellent 9 imaging surface 28; A circle that passes as rod 9 near multifilament on the inclined-plane that the front end of built-in fiber bundle 16 constitutes scribbles transparent epoxy glue 27, and remainder is filled with black epoxy glue 26; The front end of main mirror 8 is connected with the plastics needle body 24 of puncture needle 15 by locking cap 12, and its rear end is connected with the eyepiece hood 2 of ocular unit by coupling sleeve 6; Because endoscope will change disposable puncture body, its internal optics parts will be exposed to the outside inevitably the dirt environment, therefore needs in case of necessity eyepiece camera lens 3 is carried out clean wiping.Ocular unit and main mirror 8 are designed to separable form, between ocular unit and main mirror 8, cover plate 4 are set simultaneously, need with realistic use.
The front end of endoscope is provided with the requirement that meets the GB9706.1-2007 compulsory standard can carry out the azimuth sounder 20 that ultrasound wave, the signal of telecommunication or magnetic signal are surveyed.Azimuth sounder 20 can be ultrasonic detector, signal of telecommunication detector or magnetic signal detector, and it comprises signal transmitter unit, signal receiving unit 22 and signal processing unit 21 and be arranged on main mirror 8 excircles and is used for insulating base cover 11.The signal transmitter unit can be to be placed on the intravital built-in signal transmitter unit 23 of people, and this moment, signal receiving unit 22 and signal processing unit 21 were arranged on the outside of base cover 11.The signal transmitter unit also can be external signal transmitter unit 25; External signal transmitter unit 25, signal receiving unit 22 and signal processing unit 21 all are arranged on the outside of base cover 11 at this moment.Detector is arranged on the base cover 11, and then the measuring basis axis of detector overlaps with puncture needle 15, and signaling interface is arranged on the detector, can utilize this interface socket cable so that detector is powered, and the measuring-signal of detector is delivered to treatment circuit.Measuring principle is as follows: utilizing in the operation needs to renal pelvis, renal calices is introduced the process that a tubule is fetched water, to reload signal on the tubule (sound source or electromagnetic wave) generating unit, or directly utilize renal pelvis, the small water balloon that forms after renal calices is fetched water, or utilize renal pelvis, the ultrasonic echo characteristic of calyceal calculi, when puncture, do not point to renal pelvis, during renal calices, detector can be measured renal pelvis, the orientation of renal calices and actual measurement datum axis (puncture needle sensing) angle spatially, just on X and Y direction, be offset screen center at simulation luminous point on the display device, offset distance is directly proportional with the drift angle, Shou Shu operator can adjust the direction of puncture endoscope according to screen display like this, make the simulation luminous point near screen center, thereby be back on the correct puncture direction.
The parameter of part-structure of the present invention is as follows: as shown in Figure 4, the solid spine that the imaging surface 28 that multifilament passes picture rod 9 and the end of hollow outer pipe 14 constitute comprises forward puncture face 41 and the face 42 that punctures dorsad, the auxiliary puncture face 43 that is arranged on forward puncture face 41 rears that are arranged on the spine forefront, the side direction that is separately positioned on forward puncture face 41 left and right sides face 44 that punctures.When puncture needle 15 disposable uses, multifilament passes picture rod 9 and selects plastics picture fibre, and filament diameter is 12 μ m, and resolution is relatively low, but low price, suitable first-selected device as disposable puncture body.If hollow outer pipe 14 is disposable use, its hardness, wear-resistant requirement are lower, do not use special stainless steel material, can use general system needle material.Hollow outer pipe 14 diameter d:
Length L: 80～110mm; Put and stay pipe 13 diameter D:
Length l: 70～210mm; Puncture angle α: 14 °～19 °, the scope of the puncture angle α of forward puncture face 41 is: 14 °～19 °, the scope of the angle β that punctures dorsad of face 42 of puncturing dorsad is: 26 °～5 °, the scope of the auxiliary puncture angle γ of auxiliary puncture face 43 is: 40 °～10 °, the side direction puncture angle δ 1 of side direction puncture face 44 and the scope of δ 2 are: 14 °～19 °, and the lateral deflection angle
With
Scope be: 60 °～10 °.
The principle of the invention: different with the image-forming principle and the structure of classical endoscope, the present invention does not use object lens to carry out imaging, but has utilized multifilament to pass a key property of picture rod: will be delivered to other end (being the end face imaging of image transmission optical fibre and the principle that passes picture) well with information such as good object surfaces form that attaches of its end face and colors.Multifilament passes the operation principle of picture rod: light can pass to the other end from an end of thin Glass rod and not run out of excellent outside, even when thin rod was crooked, light also can be followed " bending " and propagate.In fact, light is not crooked, and it just ceaselessly reflects in the inboard of Glass rod and advances, and optically this is called total reflection.It is that, diameter certain by tens thousand of length is the optical fiber (elongated Glass rod or silk) about 4～12 microns that multifilament passes picture rod (also claiming optical fiber image transmission beam), and the optical fiber image device with the transitive graph picture of can directly receiving of assembling for one is arranged at two ends according to close relation one to one.Multifilament passes the optical signal that enters as an excellent end can be transferred to the other end, can can regard each root monofilament as a pixel element, monofilament is because by order arrangement one to one, several pixels of bright dipping end just can be formed the piece image identical with the light inputting end image information.This is the equal of in the other end imaging, can be handled the present invention just so-called " adherent observation type " by the subsequent optical system smoothly.Simultaneously, because the needle point of puncture needle position own is the surface that is attached at renal tissue, the operating position that this is also realistic, puncture needle head and multifilament can be passed the other end that is passed to multifilament biography picture rod as the good tissue image that attaches in rod surface fully, and not consider whether the puncture tube inwall takies the visual field.Certainly, leaving behind the end face this endoscope can not imaging, thereby the working substance of endoscope is apart from for being zero, and the depth of field also is zero, but this can not have influence under this specific occasion the use to this endoscope.
On lighting system, also different with classical endoscope, classical endoscope is owing to exist observation space before object lens, allow lighting fiber illumination field of view well, and after multifilament passes the picture rod and the needs sightingpiston well contacts, if use classical endoscope illumination mode, illumination light can't enter the sightingpiston that has attached multifilament biography picture rod, therefore the present invention adopts structure as shown in Figure 5 to realize illumination: multifilament passes picture rod 9 and allow injecting of light in perpendicular to the certain angle scope of its face of cylinder direction, and along each root inside of optical fibre generation light component, therefore the appearance casting skin that multifilament is passed picture rod 9 divests, built-in fiber bundle 16 usefulness black epoxy glues 26 are arranged silk at the one circle, optical fiber end is removed black glue, exposed end face is to guarantee bright dipping, and built-in fiber bundle 16 is crescent on the vertical axis direction arranges, and well contacts with hollow outer pipe 14 inwalls to guarantee one side that multifilament passes as rod 9, like this, breaking into interlacing point of puncture just in time is in the field of view edge place.With black epoxy glue 26 that built-in fiber bundle 16 row's silks are fixing, make illuminating ray there is not the component transmission to eyepiece 1 direction, only transmit the veiling glare of the image definition of can eliminating the effects of the act like this to the visual field direction; Built-in fiber bundle 16 keeps identical oblique angle with the imaging surface 28 that multifilament passes picture rod 9, its front end encloses (width smaller) with 27 glue of transparent epoxy glue one, can evenly enter multifilament to the light component of visual field like this passes as each monofilament in the rod with illumination field of view, remainder is fixed with hollow outer pipe with opaque black epoxy glue 26, the zone of avoiding not needing to observe also is illuminated, thus the veiling glare that exerts an influence and observe.
Endoscope shown in the present is the new instrument that substitutes the fistulation puncture needle, and this gets with operation is follow-up that employed PCN is not same instrument in the stone process, and PCN is an indispensable intrinsic instrument in this operation, has nothing to do with the present invention.PCN has two types in rigid kidney mirror and soft kidney mirror.Soft kidney mirror is thin, front end can turn to as required, enter renal calices easily, but handle hole is less, only be used for the treatment of keep somewhere the kidney fistulation can complete taking-up microlith.Rigid kidney mirror is thick, handle hole is big, can put into various intracavity rubbles and dislodger tool by its handle hole, is the most frequently used apparatus of PCN lithotrity.
Claims (10)
1. a percutaneous nephrolithotomy comprises ocular unit, passes as unit, main mirror (8) and lighting unit with the disposable use attaching observation type puncture endoscope of puncture body; It is characterized in that: it also comprises puncture body, and described puncture body comprises disposable puncture needle (15) and puts and stay pipe (13); The leading section of described puncture needle (15) is the spininess on band inclined-plane; Described puncture needle (15) comprises hollow outer pipe (14), plastics needle body (24); Described ocular unit comprises eyepiece hood (2), is arranged on eyepiece glass (1) and eyepiece camera lens (3) in the eyepiece hood (2); Described biography comprises that as the unit multifilament in the hollow outer pipe (14) that is arranged on puncture needle (15) passes picture rod (9), the imaging surface (28) that described multifilament passes picture rod (9) constitutes solid spine for the inclined-plane and with the leading section of hollow outer pipe (14), and it goes out image planes (5) and is connected with ocular unit; The front end of described main mirror (8) is connected with the plastics needle body (24) of puncture needle (15), and its rear end is connected with the eyepiece hood (2) of ocular unit; Described lighting unit comprises internal illumination parts and detachable illuminace component; Described internal illumination parts comprise the light beam chuck (19) that can be connected with main mirror (8), be arranged on light beam interface (17) that light beam chuck (19) goes up and can be connected with external light source, be arranged on light cone (18) in the light beam interface (17), be arranged on the interior biography light fibre bundle (10) of light beam interface (17); Described detachable illuminace component comprises the built-in fiber bundle (16) that is arranged in the puncture needle (15); Described biography light fibre bundle (10) and built-in fiber bundle (16) butt joint; The front end of described built-in fiber bundle (16) with crescent shape be distributed in multifilament pass picture rod (9) around, the front end of described built-in fiber bundle (16) constitutes one and passes the suitable inclined-plane of imaging surface (28) of picture excellent (9) with multifilament.
2. the percutaneous nephrolithotomy according to claim 1 disposable use attaching observation type puncture endoscope of puncture body is characterized in that: it is short that the front end of described built-in fiber bundle (16) passes picture rod (9) than multifilament; A circle that passes as rod (9) near multifilament on the inclined-plane that the front end of described built-in fiber bundle (16) constitutes scribbles transparent epoxy glue (27), and remainder is filled with black epoxy glue (26).
3. the percutaneous nephrolithotomy according to claim 1 and 2 disposable use attaching observation type puncture endoscope of puncture body, it is characterized in that: the solid spine that described multifilament passes as the end formation of the imaging surface (28) of rod (9) and hollow outer pipe (14) comprises the forward puncture face (41) that is arranged on the spine forefront and the face (42) that punctures dorsad, be arranged on the auxiliary puncture face (43) at forward puncture face (41) rear, be separately positioned on the side direction puncture face (44) of forward puncture face (41) left and right sides, the scope of the puncture angle α of described forward puncture face (41) is: 14 °～19 °, the scope of the angle β that punctures dorsad of the described face (42) that punctures dorsad is: 26 °～5 °, the scope of the auxiliary puncture angle γ of described auxiliary puncture face (43) is: 40 °～10 °, the side direction puncture angle δ 1 of described side direction puncture face (44) and the scope of δ 2 are: 14 °～19 °, and the lateral deflection angle
With
Scope be: 60 °～10 °.
4. the percutaneous nephrolithotomy according to claim 3 disposable use attaching observation type puncture endoscope of puncture body, it is characterized in that: described puncture endoscope also comprises azimuth sounder (20), described azimuth sounder (20) is ultrasonic detector, signal of telecommunication detector or magnetic signal detector, and it comprises signal transmitter unit, signal receiving unit (22) and signal processing unit (21) and be arranged on main mirror (8) excircle and is used for insulating base cover (11).
5. the percutaneous nephrolithotomy according to claim 4 disposable use attaching observation type puncture endoscope of puncture body, it is characterized in that: described signal transmitter unit is an external signal transmitter unit (25); Described external signal transmitter unit (25), signal receiving unit (22) and signal processing unit (21) all are arranged on the outside of base cover (11).
6. the percutaneous nephrolithotomy according to claim 5 disposable use attaching observation type puncture endoscope of puncture body, it is characterized in that: the front end of described main mirror (8) is connected with the plastics needle body (24) of puncture needle (15) by locking cap (12), and its rear end is connected with the eyepiece hood (2) of ocular unit by coupling sleeve (6).
7. the percutaneous nephrolithotomy according to claim 4 disposable use attaching observation type puncture endoscope of puncture body, it is characterized in that: described signal transmitter unit is built-in signal transmitter unit (23); Described built-in signal transmitter unit (23) is placed in the human body, and described signal receiving unit (22) and signal processing unit (21) are arranged on the outside of base cover (11).
8. the percutaneous nephrolithotomy according to claim 7 disposable use attaching observation type puncture endoscope of puncture body, it is characterized in that: the front end of described main mirror (8) is connected with the plastics needle body (24) of puncture needle (15) by locking cap (12), and its rear end is connected with the eyepiece hood (2) of ocular unit by coupling sleeve (6).
9. the percutaneous nephrolithotomy according to claim 1 and 2 disposable use attaching observation type puncture endoscope of puncture body, it is characterized in that: described puncture endoscope also comprises azimuth sounder (20), described azimuth sounder (20) is ultrasonic detector, signal of telecommunication detector or magnetic signal detector, and it comprises signal transmitter unit, signal receiving unit (22) and signal processing unit (21) and be arranged on main mirror (8) excircle and is used for insulating base cover (11).
10. the percutaneous nephrolithotomy according to claim 9 disposable use attaching observation type puncture endoscope of puncture body, it is characterized in that: the front end of described main mirror (8) is connected with the plastics needle body (24) of puncture needle (15) by locking cap (12), and its rear end is connected with the eyepiece hood (2) of ocular unit by coupling sleeve (6).
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2008102316677A CN101390770B (en) | 2008-10-09 | 2008-10-09 | Puncture body disposable adherent observation type puncture endoscope for percutaneous renal stone-extraction operation |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2008102316677A CN101390770B (en) | 2008-10-09 | 2008-10-09 | Puncture body disposable adherent observation type puncture endoscope for percutaneous renal stone-extraction operation |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN101390770A CN101390770A (en) | 2009-03-25 |
| CN101390770B true CN101390770B (en) | 2010-09-08 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN2008102316677A Expired - Fee Related CN101390770B (en) | 2008-10-09 | 2008-10-09 | Puncture body disposable adherent observation type puncture endoscope for percutaneous renal stone-extraction operation |
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| Country | Link |
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| CN (1) | CN101390770B (en) |
Families Citing this family (4)
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN103239203A (en) * | 2013-04-26 | 2013-08-14 | 广州宝胆医疗器械科技有限公司 | Percutaneous transhepatic puncture choledochoscope |
| CN103284780A (en) * | 2013-04-26 | 2013-09-11 | 广州宝胆医疗器械科技有限公司 | Puncture arthroscope |
| CN106377303A (en) * | 2016-11-18 | 2017-02-08 | 凌安东 | Abdominal wall puncture device for laparoscope based on photo-excitation laser detection positioning |
| WO2023279383A1 (en) * | 2021-07-09 | 2023-01-12 | 陈韦弘 | Cavity detection and injection composite apparatus |
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| CN101390770A (en) | 2009-03-25 |
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