CN103110457B - Mucous membrane separating scalpel - Google Patents
Mucous membrane separating scalpel Download PDFInfo
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- CN103110457B CN103110457B CN201310016386.0A CN201310016386A CN103110457B CN 103110457 B CN103110457 B CN 103110457B CN 201310016386 A CN201310016386 A CN 201310016386A CN 103110457 B CN103110457 B CN 103110457B
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- electric knife
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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, particularly relate to a kind of under scope mucosa peel off operation in can effectively avoid perforation, reduce hemorrhage mucosa separating knife.
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 is more and more ripe.But for larger smooth pathological changes, EMR is treated the method can only excised by piecemeal and carries out, and consequently can not obtain complete pathological diagnosis data, tumor by local remain and the probability that recurs larger.Under scope, mucosa decollement (ESD) produces subsequently, and achieves initial success.Can a complete resection pathological changes in ESD operation, the excision degree of depth can comprise mucosa holostrome, muscularis mucosae and large portion Submucosa, obviously reduces the residual of tumor and relapse rate.Through development for many years, ESD has been listed in a kind of new tool for the treatment of early stage Alimentary tract disease.
ESD, as the important means in Alimentary tract disease treatment, but because it is in stripping process, cannot obtain the scope visual field preferably, and make this major complications of perforation often have generation.Little perforation can be effectively closed by Titanium clip under scope, and larger then needs emergency surgery operative repair to prevent peritonitis.This complication adds the pain of patient greatly; Also for Alimentary tract disease treatment operation improves difficulty; Meanwhile, patient also limit carrying out of ESD to the worry of perforation and fear.
As another major complications in ESD treatment---hemorrhage, also normally there is considerable influence to ESD operation.Once occur hemorrhage in art, hemostasis will expend for a long time, and affects the scope visual field; Blindly be also easy to bore a hole in hemostasis; When amount of bleeding is larger, sometimes have to stop ESD.
Summary of the invention
In order to solve above-mentioned technical problem, the object of this invention is to provide a kind of mucosa separating knife, its mucosa under scope is peeled off in operation, the reasonable visual field can be obtained, avoid because camera lens cannot observe the situation that electric knife cuts off tissue, and make tissue cut off deeply, there is perforation, hemorrhage equivalent risk.It operates easily and safely, and can with conventional endoscopic with the use of performance, ESD treatment operation can be widely used in digestive system.
To achieve the above object, present invention employs following technical scheme:
A kind of mucosa separating knife, comprise support clamp, electric knife, conduit, traction steel wire, point 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 point 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 the support tong arms be hinged, two front ends supporting tong arm all have the supporting and location structure that can be fixed on mucosa, two rear ends supporting tong arm connect traction steel wire, and this traction steel wire passes conduit and is connected with the support clamp control handle controlling support clamp folding with after point lumen; Described electric knife rear end is connected with conductive filament, this conductive filament passes conduit and is fixedly connected with the electric knife control handle of retreating with control electric knife after point lumen, this conductive filament and the electrode be arranged on electric knife control handle are electrically connected, and electric knife control handle and handle are slidably connected; Described point of lumen is fixed on the near-end of conduit, and handle is fixed on one end of point lumen, and support clamp control handle is movably arranged on the other end of point lumen.
During operation, support clamp tail end traction steel wire in support clamp control handle, by the activity of support clamp control handle, controls support clamp open and close movement by tubes connection.Support clamp binding clip opens, and is propped up by pathological tissues, obtains the good visual field and obtain good feed environment for electric knife for camera lens.Electric knife by tubes connection on the electrode of electric knife control handle; Electric knife control handle controls electric knife and moves forward and backward.After pathological tissues is propped up, electric knife need cut off position from arriving diseased region between support clamp two jaw, and energising feed, cuts off pathological tissues.Support clamp struts after degree reaches capacity, and regains electric knife and closed support clamp, allows support clamp advance after a segment distance, continues the above-mentioned operation process of repetitive operation, until pathological tissues excises completely.Pathological tissues after cutting off with support clamp gripping, to make pathological analysis.
As preferably, described conduit is multi-lumen tube, and the conductive filament of described traction steel wire and electric knife is respectively by the different tracts of conduit.
As preferably, described supporting and location structure refers to that formation point protuberance is stuck up respectively to top rake in two front ends supporting tong arms.During use, this sharp protuberance and mucous membrane surface are formed to contact and are adhered fixing, and further preferably, described two support the front end of tong arms or sharp protuberance carries out surface roughening process, are adhered fixed effect to improve.
As preferably, described electric knife head is L-shaped or annular, and L shape electric knife for the pathological tissues of front width type less than normal, can carry out operation technique; Annular electro cutting knife, because being fixed on conduit in its one end, controlling ring-like electric knife forward and both sides extension movement by electric knife control handle, increases 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 being convenient to electric knife is like this moved and facilitates operation technique.Further preferably, described electric knife and conductive filament thereof are made up of same one metal wire.
The present invention is owing to have employed above technical scheme, peel off in operation for mucosa under scope, the reasonable visual field can be obtained for scope, avoid because camera lens cannot observe the situation that electric knife cuts off tissue, and make tissue cut off deeply, there is perforation, hemorrhage equivalent risk.Its outside dimension is endoscope movable detecting hole size design routinely, and its safety, operating process easily, can widely use in ESD field of surgery now.
Accompanying drawing explanation
Fig. 1 is structural representation of the present invention;
Fig. 2 is the closed schematic diagram of support clamp of the present invention;
Fig. 3 be support clamp of the present invention open schematic diagram;
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 schematic diagram of the present invention (closed mucosa separating knife is adjacent to pathological tissues, prepares to carry out cutting off tissue);
Fig. 7 is use schematic diagram (support clamp struts tissue) of the present invention;
Fig. 8 is use schematic diagram of the present invention (electric knife feed incised tissue);
Fig. 9 is use schematic diagram of the present invention (support clamp struts further, assists electric knife feed incised tissue);
Figure 10 is use schematic diagram of the present invention (pathological tissues is cut off completely);
Figure 11 is the structural representation of embodiment 2 electric knife;
Figure 12 is the axonometric chart of embodiment 2 electric knife;
Wherein, 1-support clamp; 2-electric knife; 3-conduit; 4-traction steel wire; 5-divides lumen; 6-support clamp control handle; 7-electric knife control handle; 8-electrode; 9-handle.
Detailed description of the invention
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, point 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 point 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, as shown in Fig. 2, Fig. 3, Fig. 4 and Fig. 5, described support clamp 1 comprises two the support tong arms be hinged, two front ends supporting tong arm all have the supporting and location structure that can be fixed on mucosa, two rear ends supporting tong arm connect traction steel wire 4, and through conduit 3, support clamp control handle 6 with control support clamp 1 folding rear with point lumen 5 is connected this traction steel wire 4; Described electric knife 2 rear end is connected with conductive filament, this conductive filament is fixedly connected with through conduit 3 and the rear electric knife control handle 7 of retreating with control electric knife 2 of point lumen 5, this conductive filament and the electrode 8 be arranged on electric knife control handle 7 are electrically connected, and electric knife control handle 7 and handle 9 are slidably connected; Described point of lumen 5 is fixed on the near-end of conduit 3, and handle 9 is fixed on one end of point lumen 5, and support clamp control handle 6 is movably arranged on the other end of point 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 is respectively by the different tracts of conduit 3.Described supporting and location structure refers to that formation point protuberance 11 is stuck up respectively to top rake in two front ends supporting tong arm.Front end and the sharp protuberance 11 of described two support tong arms carry out surface roughening process.Described electric knife 2 head is 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 up of same one metal wire.
Use procedure is as follows:
1, calcination labelling is carried out to the normal mucosa around diseased tissues.
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, support clamp 1 is closed, 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, obtain the good visual field for camera lens and obtain better feed environment for electric knife 2.
5, as shown in Figure 8, electric knife 2 slowly feed, energising cuts off tissue.
6, as shown in Figure 9, support clamp 1 continues to strut, to coordinate electric knife 2 to cut off tissue, until support clamp 1 struts to the limit.
7, return between electric knife 2 to support clamp 1 liang of jaw (two support tong arm), then after closed support clamp 1, allow mucosa separating knife continue to march to correct position forward.
8, repeat step 3,4,5,6, the operation of 7, until as shown in Figure 10, pathological tissues does not cut off state completely.
9, clamp pathological tissues with support clamp 1 and take out, to make pathological analysis.
Embodiment 2:
A kind of mucosa separating knife, is only from the different of embodiment 1: described conduit 3 is three lumens, and a tract leads to traction steel wire 4, another two tracts energising cutting knife 2 and conductive filament thereof.Ringwise, the lordosis section of this annular is the cut length 21 of electric knife 2 to described electric knife 2 head, and this lordosis section is positioned at two of support clamp 1 and supports between tong arms and can move forward and backward.
Mucosa separating knife of the present invention, peels off in operation for mucosa under scope, can obtain the reasonable visual field, avoid because camera lens cannot observe the situation that electric knife cuts off tissue, and make tissue cut off deeply for scope, occurs perforation, hemorrhage equivalent risk.Its outside dimension is endoscope movable detecting hole size design routinely, and its safety, operating process easily, can widely use in ESD field of surgery now.Mucosa separating knife provided by the present invention is single use instrument, avoids reusing.
It is emphasized that: be only preferred embodiment of the present invention above, not any pro forma restriction is done to the present invention; Every above embodiment is done according to technical spirit of the present invention any simple modification, equivalent variations and modification, all still belong in the scope of technical solution of the present invention.
Claims (6)
1. a mucosa separating knife, it is characterized in that, comprise support clamp (1), electric knife (2), conduit (3), traction steel wire (4), point 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 point 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 the support tong arms be hinged, two front ends supporting tong arm all have the supporting and location structure that can be fixed on mucosa, two rear ends supporting tong arm connect traction steel wire (4), and this traction steel wire (4) is connected with the support clamp control handle (6) controlling support clamp (1) folding with point lumen (5) afterwards through conduit (3); Described electric knife (2) rear end is connected with conductive filament, the electric knife control handle (7) that this conductive filament is retreated with control electric knife (2) afterwards through conduit (3) and point lumen (5) is fixedly connected with, this conductive filament and the electrode (8) be arranged on electric knife control handle (7) are electrically connected, and electric knife control handle (7) and handle (9) are slidably connected; Described point of lumen (5) is fixed on the near-end of conduit (3), handle (9) is fixed on one end of a point lumen (5), and support clamp control handle (6) is movably arranged on the other end of a point lumen (5); The cut length (21) of described electric knife (2) is positioned at two of support clamp (1) and supports between tong arms and can move forward and backward; After the front ends of two support tong arms of support clamp (1) and the mucous membrane surface of pathological tissues are fixed, support clamp (1) opens, pathological tissues is propped up, the cut length (21) of electric knife (2) supports feed between tong arms from two of support clamp (1), and energising cuts off pathological tissues.
2. a kind of mucosa separating knife according to claim 1, it 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) is respectively by 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 formation point protuberance (11) is stuck up respectively to top rake in two front ends supporting tong arm.
4. a kind of mucosa separating knife according to claim 3, is characterized in that, front end or the sharp protuberance (11) of described two support tong arms carry out surface roughening process.
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.
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 up of same one metal wire.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201310016386.0A CN103110457B (en) | 2013-01-16 | 2013-01-16 | Mucous membrane separating scalpel |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201310016386.0A CN103110457B (en) | 2013-01-16 | 2013-01-16 | Mucous membrane separating scalpel |
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| CN103110457A CN103110457A (en) | 2013-05-22 |
| CN103110457B true CN103110457B (en) | 2015-04-01 |
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| CN201310016386.0A Active CN103110457B (en) | 2013-01-16 | 2013-01-16 | Mucous membrane separating scalpel |
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Families Citing this family (9)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| 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 |
| CN107343814B (en) * | 2016-05-05 | 2023-11-03 | 中国人民解放军第二军医大学 | Slitting knife |
| CN108523985B (en) * | 2018-04-23 | 2024-05-07 | 南微医学科技股份有限公司 | Multifunctional high-frequency electric incision knife |
| CN110974355B (en) * | 2019-12-12 | 2021-02-19 | 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 |
| CN114569234B (en) * | 2021-11-19 | 2024-09-06 | 青岛市城阳区人民医院 | Multifunctional snare for endoscopic surgery |
| 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 |
| CN115177360B (en) * | 2022-08-03 | 2024-07-16 | 南昌元合泽众科技有限公司 | Multifunctional endoscope minimally invasive scalpel |
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| US6921361B2 (en) * | 2000-07-24 | 2005-07-26 | Olympus Corporation | Endoscopic instrument for forming an artificial valve |
| JP2003299667A (en) * | 2002-04-09 | 2003-10-21 | Pentax Corp | Bipolar-type high frequency cutting accessory for endoscope |
| JP3923022B2 (en) * | 2003-02-28 | 2007-05-30 | オリンパス株式会社 | Endoscopic treatment tool |
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| CN201185955Y (en) * | 2008-01-31 | 2009-01-28 | 潘文胜 | Mucosa-cutting knife under endoscope |
| CN202554059U (en) * | 2012-04-25 | 2012-11-28 | 上海埃尔顿医疗器械有限公司 | Special surgical instrument with diagonal cup-shaped pliers heads for endoscopic submucosal dissection |
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| CN103110457A (en) | 2013-05-22 |
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