CN106551672A - 子宫镜检查系统 - Google Patents

子宫镜检查系统 Download PDF

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CN106551672A
CN106551672A CN201611020781.6A CN201611020781A CN106551672A CN 106551672 A CN106551672 A CN 106551672A CN 201611020781 A CN201611020781 A CN 201611020781A CN 106551672 A CN106551672 A CN 106551672A
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CN106551672B (zh
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米拉·萨尼
森马尔·申纳－艾尔马科格鲁
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Abstract

一种子宫镜检查系统包括具有内通道的观测仪器、可去除地联接到观测仪器的护套、以及流出通道。护套具有远侧凸缘，远侧凸缘向内朝向观测仪器的外表面延伸。流出通道形成在护套的内表面和观测仪器的外表面之间。远侧凸缘形成流出通道的远端并且大致位于观测仪器和护套之间。

Description

子宫镜检查系统
本申请是2011年9月28日申请的、国际申请号为PCT/US2011/053753、中国申请号为201180046921.6、发明名称为“子宫镜检查系统”的申请的分案申请。
相关申请的交叉引用
本申请是PCT国际专利申请，要求美国专利申请序列号12/89355的优先权，其全部公开内容通过引用并入本文中。
技术领域
本发明一般地涉及子宫镜检查系统，并且更具体地涉及具有小尺寸的用于诊所环境的子宫镜检查系统。
背景技术
子宫镜检查通常指使用子宫镜在穿过子宫颈的情况下检查子宫腔。这样，子宫镜检查允许诊断子宫内的病变并且还可用于外科治疗。子宫镜通常包括观测仪器(scope)和护套。
与一些当前的子宫镜检查系统有关的一个问题是它们必须在手术室环境中使用并且病人处于某种麻醉状态下。因为当前子宫镜的尺寸大，所以尤其需要进行麻醉，这样它们可给病人导致不适和痛苦。例如，典型的子宫镜可具有约9毫米的最外直径。这种子宫镜包括具有约8毫米直径的观测仪器和具有约9毫米直径的护套。相比之下，本主题的科学文献认为仅当子宫镜的最外直径为约6毫米或更小时，可以使用能在诊所环境中进行的阴道镜检查方法来执行子宫镜检查。
与当前的观测仪器有关的另一个问题是它们通常包括位于观测仪器远端处的钝凸缘。该凸缘从观测仪器向外延伸并且使得难以(要不就不可能)在没有护套和/或没有闭塞物的情况下使用观测仪器。因此，一些当前子宫镜的尺寸受限于观测仪器和护套的尺寸，例如9毫米的直径。
因此，所需要的是一种用于诊所环境的子宫镜系统，其解决了上述以及其他问题。
发明内容
根据本发明的一个方面，一种子宫镜检查系统涉及在诊所环境中执行医疗程序。子宫镜检查系统包括观测仪器，观测仪器具有外表面、由内表面限定的内通道、以及远端。护套可去除地联接到观测仪器并且具有尖端，在该尖端处，远侧凸缘向内朝向观测仪器的外表面延伸。护套还具有内表面和在远侧凸缘附近的多个流出孔。流出通道形成在护套的内表面和观测仪器的外表面之间，远侧凸缘形成流出通道的远端。手术通道形成在观测仪器的内通道中，用于接收手术工具和流入流体中的至少一个，并且显像通道形成为邻近于手术通道，用于接收显像装置。
根据本发明的另一个方面，一种用于医疗程序的子宫镜检查系统包括具有细长管状构件的形式的观测仪器，观测仪器具有外表面和内表面。观测仪器的内表面限定观测仪器的内通道。护套具有细长管状构件的形式，护套可去除地联接到观测仪器，护套具有外表面和内表面。护套具有在护套的远端处向内朝向观测仪器的外表面延伸的凸缘。手术构件位于观测仪器的内通道中并且具有细长D形管状构件的形式。手术构件具有外表面和内表面，该外表面与观测仪器的内表面隔开以形成显像通道。
根据本发明的另一个方面，一种子宫镜检查系统包括观测仪器和护套，观测仪器具有外表面和内通道，护套可去除地联接到观测仪器。护套具有内表面和远侧凸缘，远侧凸缘向内朝向观测仪器的外表面延伸。流出通道形成在护套的内表面和观测仪器的外表面之间，远侧凸缘形成观测仪器和护套之间的流出通道的远端。
鉴于参照附图作出的各种实施例的详细描述，本领域普通技术人员将会明白本发明的其他方面，下面给出附图的简要说明。
附图说明
图1是子宫镜系统的透视图。
图2A是子宫镜系统的远端的放大透视图。
图2B是子宫镜系统的远端的放大侧视图。
图2C是子宫镜系统的远端的放大剖面端视图。
图2D是子宫镜系统的远端的放大剖面顶视图。
图3示出了与图2A的远端相关联的尺寸。
图4是子宫镜系统的透视图，护套已从观测仪器移除。
图5是图4的子宫镜系统的远端的放大透视图。
图6是子宫镜系统的替代实施例的透视图。
虽然本发明可能有各种修改和替代形式，已经在附图中以示例的方式示出了特定实施例并且将在本文中对其进行详细描述。然而应当理解的是本发明不意图限于所公开的具体形式。相反，本发明将会覆盖落入本发明的精神和范围内的所有修改、等同物和替代形式，本发明的精神和范围由所附权利要求限定。
具体实施方式
参照图1，子宫镜系统100包括子宫镜102，子宫镜102具有护套104、流入阀106、流出阀108、光柱110以及碎分器112，等等。护套104是具有远端114和近端116的大致细长管状构件。子宫镜系统100还包括臂117，臂117连接到成像装置(例如照相机)，以捕捉经由显像装置(例如显像装置124)接收的图像。
根据一些示例性实施例，子宫镜系统100意图用具有足够小直径的观测仪器和附件来碎分子宫病变，能够使用阴道镜检查方法将所述观测仪器和附件插入病人的子宫中。具体地，子宫镜系统100提供了一种方式来最小化病人的痛苦，因为通常不使用持钩(tenanculum)和张开器。
此外，不需要麻醉并且可以在诊所环境中进行医疗程序。这可导致例如更快的手术以及更少的痛苦和更快的恢复，并且可能降低手术成本。子宫镜系统100的另一个优点在于外科医生可以根据病人情况来选择决定他们更愿意用较大的流量计(例如，在护套104被联接的情况下)还是更愿意用较小直径的仪器(例如，在护套104被去除的情况下)。
参照图2A，护套104可去除地联接到观测仪器118，其是(类似于护套104)具有远端114和近端116的大致细长管状构件。更特别地，护套104以重叠的方式可滑动地配合在观测仪器118中。观测仪器118包括手术构件120，其是细长D形管状构件的形式。
手术构件120在内部接收手术工具122，手术工具122可选自多种不同的工具。例如，手术工具122可以是旋转碎分器、往复碎分器或者是具有往复和旋转能力的碎分器。观测仪器118还包括显像装置124。显像装置124邻近于手术构件120并且可包括各种图像装置。例如，显像装置124可包括用于照明和图像传输的光纤技术。
为了保持连续的流出，在护套104的远端114附近形成了多个流出孔126。流入阀106(图1中示出)调节液体通过手术构件120的流入量，如从手术构件120延伸的箭头107所表示的。液体例如用于扩张或冲洗病人的子宫。此外，通常从进入泵(access pump)接收液体，进入泵输送流体以在关节腔(例如，子宫)中产生基本恒定的预定压力水平。流出阀108(图1中示出)调节液体经由形成在护套104和观测仪器118之间的流出通道128通过流出孔126的流出量。液体的流出由延伸到流出孔126中的箭头109表示。流出液体通常被送至废物容器。
参照图2B，护套104在远端114处具有凸缘130，凸缘130向内朝向观测仪器118延伸以形成流出通道128的封闭端(图2C中示出)。凸缘130具有大致椭圆形状并且包括两对相对的侧面130a-130d。
根据所示的实施例，凸缘130的形状是非均匀的。例如，第二侧面130b比第一侧面130a向内朝向观测仪器118的中心延伸更大的距离。类似地，基于该实施例的对称特征，第四侧面130d比第三侧面130c向内朝向观测仪器118的中心延伸更大的距离。在替代实施例中，凸缘130可以具有不同的形状和尺寸。
参照图2C-2D，护套104具有外表面104a和内表面104b，并且观测仪器118具有外表面118a和内表面118b。护套104的内表面104b限定内通道，观测仪器118和显像装置124位于该内通道中。观测仪器118的内表面118b限定内通道，外构件以及手术工具122位于该内通道中。
手术构件120具有外表面120a、内表面120b和平的外表面120c(图2C清楚地示出)。平的外表面120c与观测仪器118的内表面118b隔开以形成显像通道132(图2C清楚地示出)，显像装置124位于该显像通道132中。显像通道132仅仅是观测仪器118的更大的内通道的一小部分。
流出通道128形成在护套104的内表面104b和观测仪器118的外表面118a之间。流入通道134形成在观测仪器118的内通道中。如果手术工具122被去除，则流入通道134就是观测仪器118的整个内通道。如果手术工具122就位，则流入通道134被限制到手术工具122和手术构件120的内表面120b之间的区域。
参照图3，子宫镜检查系统100被设计成具有可用于诊所环境的尺寸。特别地，最外直径被设计成约为6毫米或更小。根据所示的实施例，护套104的外直径D1(其与外表面104b的直径相同)约为5.6毫米。例如，在替代实施例中，护套104的直径为5.5毫米。手术工具122(例如，碎分器)的外直径D2约为2.9毫米。
观测仪器118具有长直径D3约为5.15毫米并且短直径D4约为4.6毫米的椭圆形状。手术构件120具有约3.1毫米的弯曲尺寸L1和约3.95毫米的平尺寸L2。
子宫镜检查系统100的相对小尺寸允许病人在诊所环境中得到治疗。一般地，可使用当前的子宫镜检查系统100给病人提供医疗程序，使得不需要或者需要极少的麻醉。显然，子宫镜检查系统100的一个优点在于其在直径上小到足以适合于阴道镜检查方法。
参照图4，子宫镜检查系统100还可用于没有护套104的情况，而依然经由诊断插管135(例如，直径约为2.9毫米的插管)提供连续的流。特别地，护套104被去除以允许仅将观测仪器118插入病人体内，例如插入子宫内。护套104的去除减小了子宫镜检查系统100的最外直径。例如，根据上面参照图3所描述的尺寸，最外直径从约5.6毫米(外直径D1)减小到约5.15毫米(长直径D3)。当护套104被去除时，可通过诸如上述碎分器112(图1-3示出)的手术工具或者通过诊断插管135来提供流出。
与先前的观测仪器相比，观测仪器118不具有从其远端向外延伸的凸缘。先前的观测仪器的向外延伸凸缘不必要地增大了各自观测仪器的最外直径并且产生了侵扰性的远端，其使得难以(要不就不可能)在没有护套和闭塞物的情况下引入病人体内。
参照图5，当护套104被去除时，子宫镜检查系统可用于诊断目的。护套104通常可以用在手术情况中以在引入碎分器叶片之前清空视野。诊断插管135(其具有远端136)用于产生系统的较小总体直径以便于诊断目的。根据上述尺寸，可通过去除护套104来实现大约0.5毫米的减小。插管135的另一优点在于其可被制作成是可重复使用的。插管135的又一优点在于其可用于在诊断程序期间扩张和冲洗病人的子宫。
插管135允许连续的流出，但不延伸超过观测仪器118的远端。例如，插管135提供流出通道128的代替物，在去除护套104的情况下流出通道128被去除。特别地，插管135提供替代的流出通道138以代替由护套104形成的流出通道128。这样，即使去除了护套104仍可以保持连续的流。
参照图6，子宫镜系统100替代地包括插入手术构件120中的流动装置140。流动装置140具有流入管状元件142和流出管状元件144，其可以是结合的元件或者分离的元件。
管状元件142、144的远端终止于手术构件120中的不同位置。优选地，流入管状元件142的远端终止于观测仪器118的远端114处，并且流出管状元件144的远端在手术构件120中终止在离远端114一定距离处。管状元件142、144终止在沿着手术构件120的不同位置，这消除了流体短路的可能性并且提供了更佳的循环，从而提供子宫内的冲洗。
根据一个示例，流动装置140由不锈钢制成并且这样就可以是可重复使用的装置。根据另一示例，流动装置140由更加有成本效益的材料制成，例如聚合物。如果使用聚合物，则流动装置140通常被认为是单次使用装置。
实践中，例如，外科医生会将流动装置140插入子宫镜102的手术构件120中，然后插入病人的子宫中。在子宫镜引入子宫中之后，流动装置140的流入阀146将被打开并且子宫将被扩张。然后，通过打开流动装置140的流出阀148而实现冲洗。在诊断程序的情况下，流动装置140可在手术的持续期间留在适当位置。在手术程序的情况下，流动装置140被去除并且手术工具(例如碎分器112)被插入观测仪器118中。
尽管已经详细描述了用于实施本发明的最佳模式，但本发明相关领域的技术人员将会认识到所附权利要求范围内的用于执行本发明的各种替代设计和实施例。例如，护套104、观测仪器118和手术工具122可以是圆形、椭圆形或者任何其他平滑的形状(即，非侵扰性的，例如不具有向外延伸凸缘的形状)。在另一示例中，手术构件120可具有圆形或任何其他与所示D形类似的形状。

Claims (20)

1.一种子宫镜检查系统，包括：
外部构件，所述外部构件具有外表面，所述外表面具有从所述外部构件的远端延伸所述外部构件的长度的至少一部分的恒定横截面；
内部构件，所述内部构件位于所述外部构件的内部，所述内部构件在所述内部构件的内部限定所述子宫镜检查系统的内通道；以及
护套，所述护套可去除地联接到所述外部构件并且包围所述外部构件，所述护套包括管，所述管的远端呈凸缘的形状，所述凸缘朝向所述外部构件的外表面延伸；
其中，所述外部构件的外表面和所述凸缘形成所述管与所述外部构件之间的外通道的封闭端。
2.如权利要求1所述的子宫镜检查系统，其中，所述凸缘的第一部分朝向所述外部构件的外表面延伸第一距离，所述凸缘的第二部分朝向所述外部构件的外表面延伸第二距离，所述第一距离大于所述第二距离。
3.如权利要求1所述的子宫镜检查系统，其中，所述外部构件的外表面的恒定横截面从所述外部构件的远端至少延伸所述凸缘的厚度。
4.如权利要求1所述的子宫镜检查系统，其中，在所述护套联接到所述外部构件的情况下，所述外部构件的远端和所述护套的远端对齐。
5.如权利要求1所述的子宫镜检查系统，其中，所述外部构件和所述内部构件在所述内部构件与所述外部构件之间限定子宫镜检查系统的显像通道。
6.如权利要求1所述的子宫镜检查系统，其中，所述护套的外直径为大致5.6毫米。
7.如权利要求6所述的子宫镜检查系统，其中，所述护套的外直径为大致4.6至5.15毫米。
8.如权利要求1所述的子宫镜检查系统，其中，所述护套具有位于所述护套的远端附近的多个流出孔。
9.如权利要求1所述的子宫镜检查系统，其中，所述凸缘朝向所述外部构件的外表面延伸的距离变化。
10.如权利要求9所述的子宫镜检查系统，其中，所述外部构件在外部构件的远端处的径向横截面具有半球形形状，其中平坦对称侧位于球形对称侧之间。
11.如权利要求10所述的子宫镜检查系统，其中，所述凸缘邻近所述外部构件的平坦对称侧延伸的距离大于邻近所述球形对称侧延伸的距离。
12.一种子宫镜检查系统，包括：
观测仪器，所述观测仪器具有外表面和内表面，所述外表面沿着观测仪器的长度具有均匀的横截面；
手术构件，所述手术构件位于所述观测仪器内并且具有外表面和内表面，所述手术构件的内表面限定手术通道，所述手术构件的外表面的至少一部分和所述测量仪器的内表面限定显像通道；以及
护套，所述护套可去除地联接到所述观测仪器并且包围所述观测仪器，所述护套包括管，所述管的远端呈凸缘的形状，所述凸缘朝向所述观测仪器的外表面延伸；
其中，所述观测仪器的外表面和所述管的内表面形成流出通道，所述凸缘抵接所述观测仪器的外表面以形成所述流出通道的端部。
13.如权利要求12所述的子宫镜检查系统，其中，所述观测仪器在观测仪器的远端处的径向横截面形成具有平坦对称侧的球形。
14.如权利要求13所述的子宫镜检查系统，其中，所述护套的外表面在护套的远端处的径向横截面是球形。
15.如权利要求12所述的子宫镜检查系统，其中，所述显像通道被构造成接收显像装置。
16.如权利要求12所述的子宫镜检查系统，其中，所述护套的外直径是大致5.6毫米。
17.如权利要求16所述的子宫镜检查系统，其中，所述观测仪器的外直径是大致4.6至5.15毫米。
18.如权利要求12所述的子宫镜检查系统，其中，所述手术构件的径向横截面形成水平的D形形状。
19.如权利要求12所述的子宫镜检查系统，还包括位于所述手术通道内的外科工具。
20.一种子宫镜检查系统，包括：
观测仪器，所述观测仪器具有外表面和内表面，所述外表面沿着观测仪器的长度具有均匀的径向横截面和大致4.6至5.15毫米的直径；以及
护套，所述护套可去除地联接到所述观测仪器并且包围所述观测仪器，所述护套包括管和在所述管的远端处的凸缘，所述管具有内表面和直径大致5.6毫米的外表面，所述管的内表面沿着护套的长度具有均匀的径向横截面；
其中，所述观测仪器的外表面和所述管的内表面形成流出通道，且所述凸缘抵接所述观测仪器的外表面以形成所述流出通道的端部。
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