CN103110457A - Mucous membrane separating scalpel - Google Patents
Mucous membrane separating scalpel Download PDFInfo
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- CN103110457A CN103110457A CN2013100163860A CN201310016386A CN103110457A CN 103110457 A CN103110457 A CN 103110457A CN 2013100163860 A CN2013100163860 A CN 2013100163860A CN 201310016386 A CN201310016386 A CN 201310016386A CN 103110457 A CN103110457 A CN 103110457A
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Abstract
The invention discloses a mucous membrane separating scalpel which comprises support pliers and an electric cutter. The support pliers comprise two support plier arms which are mutually hinged. The front ends of the two support plier arms are provided with two support positioning structures capable of being fixed on a mucous membrane. The back ends of the two support plier arms are connected with a guide steel wire which penetrates through a catheter and a chamber-separating catheter and is connected with a control handle. The back end of the electric cutter is connected with a conduction wire which penetrates through the catheter and the chamber-separating catheter and is fixedly connected with the control handle and is in electrical connection with an electrode of the electric cutter control handle which is connected with a handle in a sliding mode. The chamber-separating catheter is fixed at a near end of the catheter. The handle is fixed at one end of the chamber-separating catheter. Control handles of the support pliers are moveably arranged at the other end of the chamber-separating catheter. During a mucous membrane stripping surgery under a endoscope, the mucous membrane separating scalpel can obtain good vision, avoid the situation that tissue cutting is too deep, and perforation, bleeding and other risks are caused because a camera can not show tissue cutting of the electric cutter.
Description
Technical field
The invention belongs to technical field of medical instruments, relate in particular to a kind of under scope mucosa peel off and can effectively avoid boring a hole, reducing hemorrhage mucosa separating knife in the operation.
Background technology
Along with the development of digestive endoscopy technology, the Endoscopic Treatment of digestive tract disease is more and more universal.Endoscopic mucosal resection art (EMR) from the polypectomy of nineteen sixty-eight to the eighties in 20th century, treatment technology are more and more ripe.But for larger smooth pathological changes, the EMR treatment can only be undertaken by the method for piecemeal excision, consequently can not obtain complete pathological diagnosis data, and tumor by local probability residual and recurrence is larger.Mucosa decollement (ESD) produces under the scope subsequently, and has obtained initial success.Can a complete resection pathological changes in the ESD operation, the excision degree of depth can comprise mucosa holostrome, muscularis mucosae and large section Submucosa, obviously reduces the residual and relapse rate of tumor.Through development for many years, ESD has been listed in a kind of new tool for the treatment of early stage digestive tract pathological changes.
ESD is as the important means in the digestive tract pathological changes treatment, but because of its in stripping process, can't obtain the preferably scope visual field, and make this major complications of perforation that generation often be arranged.It is closed that little perforation can accompany effect by Titanium under the scope, and larger then needs the emergency surgery operative repair to prevent peritonitis.This complication has increased patient's pain greatly; Also improved difficulty for digestive tract pathological changes treatment operation; Simultaneously, the patient has also limited carrying out of ESD to worry and the fear of perforation.
As another major complications in the ESD treatment---hemorrhage, also operation normally has considerable influence to ESD.In case occur hemorrhagely, hemostasis will expend for a long time, and affects the scope visual field in the art; Blindly also be easy to bore a hole in the hemostasis; When amount of bleeding was larger, ESD sometimes had to end.
Summary of the invention
In order to solve above-mentioned technical problem, the purpose of this invention is to provide a kind of mucosa separating knife, its mucosa under scope is peeled off in the operation, can obtain the reasonable visual field, avoid to observe the situation that electric knife cuts off tissue because of camera lens, and it is dark that tissue was cut off, and perforation, hemorrhage equivalent risk occur.It operates easily and safely, and the performance that can be used with conventional scope, can be widely used in ESD treatment operation in the digestive system.
To achieve the above object, the present invention has adopted following technical scheme:
A kind of mucosa separating knife, comprise support clamp, electric knife, conduit, traction steel wire, minute lumen, support clamp control handle, electric knife control handle, electrode, handle, support clamp and electric knife are arranged on the far-end of conduit, and minute lumen, support clamp control handle, electric knife control handle, electrode and handle are arranged on the near-end of conduit; Wherein, described support clamp comprises two support tong arms that are hinged, two front ends that support tong arm all have the supporting and location structure that can be fixed on the mucosa, two rear ends of supporting tong arm connect traction steel wire, and the support clamp control handle with the folding of control support clamp after this traction steel wire passes conduit and is connected lumen is connected; Described electric knife rear end is connected with conductive filament, electric knife control handle with control electric knife advance and retreat after this conductive filament passes conduit and divides lumen is fixedly connected with, this conductive filament and the electrode electrical connection that is installed on the electric knife control handle, electric knife control handle and handle are slidingly connected; Described minute lumen is fixed on the near-end of conduit, and handle is fixed on an end of minute lumen, and the support clamp control handle is movably arranged on the other end of minute lumen.
During operation, the support clamp tail end is connected in the support clamp control handle with traction steel wire by conduit, by the activity of support clamp control handle, and the open and close movement of control support clamp.The support clamp binding clip opens, and pathological tissues is propped up, for camera lens obtains preferably the visual field and obtains preferably feed environment for electric knife.Electric knife is connected on the electrode of electric knife control handle by conduit; Electric knife control handle control electric knife moves forward and backward.After pathological tissues was propped up, electric knife need cut off the position from arriving diseased region between support clamp two jaws, and the energising feed cuts off pathological tissues.After support clamp struts degree and reaches capacity, regain electric knife and closed support clamp, allow support clamp advance behind the segment distance, continue the above-mentioned operation process of repetitive operation, until pathological tissues excises fully.Pathological tissues after cutting off with the support clamp gripping is in order to do the pathology analysis.
As preferably, described conduit is multi-lumen tube, and the conductive filament of described traction steel wire and electric knife is the different tracts by conduit respectively.
As preferably, described supporting and location structure refers to that two front ends that support tong arms turn forward respectively and sticks up formation point protuberance.During use, this point protuberance and mucous membrane surface form that contact glutinous fixed fixed, further preferred, and described two front ends that support tong arms or sharp protuberances carry out surface roughening to be processed, and stick fixed and decide effect to improve.
As preferably, described electric knife head is L-shaped or annular, and L shaped electric knife can for the pathological tissues of the place ahead width type less than normal, carry out operation technique; The annular electro cutting knife is fixed on the conduit because of the one end, controls ring-like electric knife by the electric knife control handle and reaches forward the both sides extension movement, has strengthened the operation technique scope, can mainly tackle in the larger pathological tissues of area.The cut length of described electric knife also can move forward and backward between two support tong arms of support clamp.The location of being convenient to like this electric knife is moved and is made things convenient for operation technique.Further preferred, described electric knife and conductive filament thereof are made by same one metal wire.
The present invention is owing to adopted above technical scheme, peel off operation for mucosa under the scope, can obtain the reasonable visual field for scope, avoid to observe the situation that electric knife cuts off tissue because of camera lens, and it is dark that tissue was cut off, and perforation, hemorrhage equivalent risk occur.Its outside dimension is the endoscope movable detecting hole size design routinely, with and safety, easily operating process, can be widely used in the ESD field of surgery now.
Description of drawings
Fig. 1 is structural representation of the present invention;
Fig. 2 is the closed sketch map of support clamp of the present invention;
Fig. 3 is the sketch map that opens of support clamp of the present invention;
Fig. 4 is the structural representation of embodiment 1 electric knife;
Fig. 5 is the axonometric chart of embodiment 1 electric knife;
Fig. 6 is use sketch map of the present invention (closed mucosa separating knife is adjacent to pathological tissues, prepares to cut off tissue);
Fig. 7 is use sketch map of the present invention (support clamp struts tissue);
Fig. 8 is use sketch map of the present invention (electric knife feed incised tissue);
Fig. 9 is use sketch map of the present invention (support clamp further struts, and assists electric knife feed incised tissue);
Figure 10 is use sketch map of the present invention (pathological tissues is cut off fully);
Figure 11 is the structural representation of embodiment 2 electric knives;
Figure 12 is the axonometric chart of embodiment 2 electric knives;
Wherein, 1-support clamp; The 2-electric knife; The 3-conduit; The 4-traction steel wire; 5-divides lumen; 6-support clamp control handle; 7-electric knife control handle; The 8-electrode; The 9-handle.
The specific embodiment
Below in conjunction with accompanying drawing the specific embodiment of the present invention is made a detailed explanation.
Embodiment 1:
A kind of mucosa separating knife as shown in Figure 1, comprise support clamp 1, electric knife 2, conduit 3, traction steel wire 4, minute lumen 5, support clamp control handle 6, electric knife control handle 7, electrode 8, handle 9, support clamp 1 and electric knife 2 are arranged on the far-end of conduit 3, and minute lumen 5, support clamp control handle 6, electric knife control handle 7, electrode 8 and handle 9 are arranged on the near-end of conduit 3; Wherein, such as Fig. 2, Fig. 3, Fig. 4 and shown in Figure 5, described support clamp 1 comprises two support tong arms that are hinged, two front ends that support tong arm all have the supporting and location structure that can be fixed on the mucosa, two rear ends of supporting tong arm connect traction steel wire 4, are connected with the support clamp control handle 6 of control support clamp 1 folding after this traction steel wire 4 passes conduit 3 and is connected lumen 5; Described electric knife 2 rear ends are connected with conductive filament, this conductive filament passes conduit 3 and is fixedly connected with minute lumen 5 rear electric knife control handles 7 with control electric knife 2 advance and retreat, this conductive filament and electrode 8 electrical connections that are installed on the electric knife control handle 7, electric knife control handle 7 is slidingly connected with handle 9; Described minute lumen 5 is fixed on the near-end of conduit 3, and handle 9 is fixed on an end of minute lumen 5, and support clamp control handle 6 is movably arranged on the other end of minute lumen 5.
In the present embodiment, described conduit 3 is double lumen tube, and the conductive filament of described traction steel wire 4 and electric knife 2 passes through respectively the different tracts of conduit 3.Described supporting and location structure refers to that two front ends that support tong arms turn forward respectively and sticks up formation point protuberance 11.Described two front end and sharp protuberances 11 that support tong arm carry out the surface roughening processing.Described electric knife 2 heads are L-shaped, and the cut length 21 of described electric knife 2 also can move forward and backward between two support tong arms of support clamp 1.Described electric knife 2 and conductive filament thereof are made by same one metal wire.
Use procedure is as follows:
1, the normal mucosa around diseased tissues is carried out the calcination labelling.
2, carry out local injection for pathological tissues, mucosa is fully swelled, be convenient to cutting and peel off.
3, as shown in Figure 6, with support clamp 1 closure, and support clamp 1 front end binding clip is adjacent to the pathological tissues edge of protuberance.
4, as shown in Figure 7, support clamp 1 is strutted slightly, for camera lens obtains preferably the visual field and obtains better feed environment for electric knife 2.
5, as shown in Figure 8, electric knife 2 slow feeds, energising cuts off tissue.
6, as shown in Figure 9, support clamp 1 continues to strut, and cuts off tissue to cooperate electric knife 2, until support clamp 1 struts to the limit.
7, return electric knife 2 between 1 liang of jaw of support clamp (two support tong arm), behind the closed support clamp 1, allow the mucosa separating knife continue to march to forward correct position again.
8, repeating step 3,4,5,6,7 operation, until as shown in figure 10, pathological tissues does not cut off state fully.
9, clamp pathological tissues and taking-up with support clamp 1, in order to do the pathology analysis.
Embodiment 2:
A kind of mucosa separating knife only is from the different of embodiment 1: described conduit 3 is three lumens, the logical traction steel wire 4 of tract, in addition two tracts energising cutting knifes 2 and conductive filament thereof.Described electric knife 2 heads ringwise, this annular lordosis section is the cut length 21 of electric knife 2, this lordosis section is positioned at two of support clamp 1 and supports between the tong arms and can move forward and backward.
Mucosa separating knife of the present invention is peeled off operation for mucosa under the scope, can obtain the reasonable visual field for scope, avoid can't observing the situation that electric knife cuts off tissue because of camera lens, and it is dark that tissue was cut off, and perforation, hemorrhage equivalent risk occur.Its outside dimension is the endoscope movable detecting hole size design routinely, with and safety, easily operating process, can be widely used in the ESD field of surgery now.Mucosa separating knife provided by the present invention is disposable tool using, avoids reusing.
It is emphasized that: above only is preferred embodiment of the present invention, is not that the present invention is done any pro forma restriction; Every foundation technical spirit of the present invention all still belongs in the scope of technical solution of the present invention any simple modification, equivalent variations and modification that above embodiment does.
Claims (6)
1. mucosa separating knife, it is characterized in that, comprise support clamp (1), electric knife (2), conduit (3), traction steel wire (4), minute lumen (5), support clamp control handle (6), electric knife control handle (7), electrode (8), handle (9), support clamp (1) and electric knife (2) are arranged on the far-end of conduit (3), and minute lumen (5), support clamp control handle (6), electric knife control handle (7), electrode (8) and handle (9) are arranged on the near-end of conduit (3); Wherein, described support clamp (1) comprises two support tong arms that are hinged, two front ends that support tong arm all have the supporting and location structure that can be fixed on the mucosa, two rear ends of supporting tong arm connect traction steel wire (4), are connected with the support clamp control handle (6) of control support clamp (1) folding after this traction steel wire (4) passes conduit (3) and is connected lumen (5); Described electric knife (2) rear end is connected with conductive filament, this conductive filament passes conduit (3) and is fixedly connected with the rear electric knife control handle (7) with control electric knife (2) advance and retreat of minute lumen (5), this conductive filament and electrode (8) electrical connection that is installed on the electric knife control handle (7), electric knife control handle (7) is slidingly connected with handle (9); Described minute lumen (5) be fixed on the near-end of conduit (3), handle (9) is fixed on an end of a minute lumen (5), support clamp control handle (6) is movably arranged on the other end of a minute lumen (5).
2. a kind of mucosa separating knife according to claim 1 is characterized in that, described conduit (3) is multi-lumen tube, and the conductive filament of described traction steel wire (4) and electric knife (2) passes through respectively the different tracts of conduit (3).
3. a kind of mucosa separating knife according to claim 1 is characterized in that, described supporting and location structure refers to that two front ends that support tong arms turn forward respectively and sticks up formation point protuberance (11).
4. a kind of mucosa separating knife according to claim 3 is characterized in that, described two front end or sharp protuberances (11) that support tong arm carry out the surface roughening processing.
5. a kind of mucosa separating knife according to claim 1 is characterized in that, described electric knife (2) head is L-shaped or annular, and the cut length (21) of described electric knife (2) is positioned at two of support clamp (1) and supports between the tong arms and can move forward and backward.
6. a kind of mucosa separating knife according to claim 5 is characterized in that, described electric knife (2) and conductive filament thereof are made by same one metal wire.
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Cited By (8)
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CN105434038A (en) * | 2015-12-15 | 2016-03-30 | 安瑞医疗器械(杭州)有限公司 | Multifunctional high-frequency tool for endoscope |
CN107343814A (en) * | 2016-05-05 | 2017-11-14 | 中国人民解放军第二军医大学 | A kind of incision knife |
CN108523985A (en) * | 2018-04-23 | 2018-09-14 | 南京微创医学科技股份有限公司 | A kind of multifunctional high frequency cutting is operated on |
CN110974355A (en) * | 2019-12-12 | 2020-04-10 | 郑由周 | ESD surgical tool |
CN111166464A (en) * | 2019-12-27 | 2020-05-19 | 范东香 | Endoscope tissue cutting knife |
CN113229893A (en) * | 2021-05-05 | 2021-08-10 | 苏州市倍若微医疗器械有限公司 | Medical surgical scissors with function of separating obstacle |
CN114469328A (en) * | 2022-01-26 | 2022-05-13 | 中国人民解放军北部战区总医院 | Supporting type high-frequency electric cutter for endoscopic submucosal dissection and use method |
CN115177360A (en) * | 2022-08-03 | 2022-10-14 | 宁波唯杰医疗科技有限公司 | Multifunctional endoscope minimally invasive scalpel |
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Cited By (15)
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US10470816B2 (en) | 2015-12-15 | 2019-11-12 | Anrei Medical (Hangzhou) Co., Ltd. | Multi-function high-frequency tool for endoscope |
CN105434038B (en) * | 2015-12-15 | 2018-07-06 | 安瑞医疗器械(杭州)有限公司 | A kind of endoscope-use multifunctional high frequency cutter |
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CN107343814B (en) * | 2016-05-05 | 2023-11-03 | 中国人民解放军第二军医大学 | Slitting knife |
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CN108523985A (en) * | 2018-04-23 | 2018-09-14 | 南京微创医学科技股份有限公司 | A kind of multifunctional high frequency cutting is operated on |
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CN110974355A (en) * | 2019-12-12 | 2020-04-10 | 郑由周 | ESD surgical tool |
CN111166464A (en) * | 2019-12-27 | 2020-05-19 | 范东香 | Endoscope tissue cutting knife |
CN113229893A (en) * | 2021-05-05 | 2021-08-10 | 苏州市倍若微医疗器械有限公司 | Medical surgical scissors with function of separating obstacle |
CN114469328B (en) * | 2022-01-26 | 2023-09-22 | 中国人民解放军北部战区总医院 | Support type high-frequency electric cutter for endoscopic submucosal stripping and use method |
CN114469328A (en) * | 2022-01-26 | 2022-05-13 | 中国人民解放军北部战区总医院 | Supporting type high-frequency electric cutter for endoscopic submucosal dissection and use method |
CN115177360A (en) * | 2022-08-03 | 2022-10-14 | 宁波唯杰医疗科技有限公司 | Multifunctional endoscope minimally invasive scalpel |
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