CN108158648A - 钬激光光纤导引器及带有电切镜和导引器的治疗装置 - Google Patents

钬激光光纤导引器及带有电切镜和导引器的治疗装置 Download PDF

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CN108158648A
CN108158648A CN201810150527.0A CN201810150527A CN108158648A CN 108158648 A CN108158648 A CN 108158648A CN 201810150527 A CN201810150527 A CN 201810150527A CN 108158648 A CN108158648 A CN 108158648A
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李利剑
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SHIMIAN COUNTY HOSPITAL OF TRADITIONAL CHINESE MEDICINE
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B18/26Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor for producing a shock wave, e.g. laser lithotripsy
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B18/24Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor with a catheter
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00505Urinary tract
    • A61B2018/00517Urinary bladder or urethra
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2218/00Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2218/001Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
    • A61B2218/002Irrigation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2218/00Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2218/001Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
    • A61B2218/007Aspiration

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Abstract

本发明公开了一种钬激光光纤导引器及带有电切镜和导引器的治疗装置,涉及医疗用品领域。钬激光光纤导引器包括具有柔性的导引管和连接在导引管一端的导引器头,导引管内具有光纤孔,导引器头内具有与光纤孔连通的空腔,导引器头外套盖有柔性封帽。带有电切镜和导引器的治疗装置包括电切镜,电切镜包括电切环管和具有密封件的操作柄连接头,电切环管内具有电切环孔,操作柄连接头内具有电切环进入孔,密封件内具有与电切环进入孔连通的密封件孔;还包括上述钬激光光纤导引器,导引管穿过密封件孔、电切环进入孔和电切环孔,导引管与密封件间密封,导引器头位于操作柄连接头外侧。本发明适用于膀胱腔内碎石或尿道狭窄钬激光内切开术。

Description

钬激光光纤导引器及带有电切镜和导引器的治疗装置
技术领域
本发明涉及医疗用品领域,尤其涉及一种钬激光光纤导引器及带有电切镜和导引器的治疗装置。
背景技术
目前膀胱结石的治疗有开放手术取石和不开刀的膀胱腔内碎石,膀胱腔内碎石采取的碎石方式有膀胱大力碎石钳、气压弹道、超声碎石、钬激碎石4种。
膀胱大力碎石钳碎石方式进行膀胱腔内碎石,要用专用碎石镜,且在进行操作时因为碎石钳占据较多腔内通道,镜身较细,通光量少,视野昏暗,又不能边冲洗边出水,使视野一直保持清晰,在刚刚进行碎石时尚能看清,碎石后因结石碎屑、膀胱壁出血,都会造成视野昏暗不清,经常要中断碎石进行冲洗,操作极为不便,目前基本上淘汰。
在基层医院因为病人数量和资金的原因,通常不会将气压弹道、超声碎石、钬激光碎石等几种设备都配齐。钬激光具有碎石与切开的功能,在高硬度结石的处理上更是气压弹道、超声碎石不能相比的,用它还可以通过输尿管软镜进行碎石,所以钬激光与其它二种相比更为泌尿外科医生所喜爱。如果基层医院要配备泌尿系结石的碎石治疗设备的话,通常首选就是钬激光。目前很多基层医院处理泌尿系结石都只配备了钬激光。但是现在没有专用的钬激光膀胱碎石镜,只能采用钬激光通过膀胱尿道镜进行膀胱尿道碎石或者尿道内切开操作。
膀胱镜只有一个入水通道,不能一边冲入水,一边让水流出,操作时只能间隙地进水或出水。钬激光通过膀胱尿道镜进行膀胱尿道碎石或者尿道内切开操作时产生的结石碎屑、膀胱壁出血,都会造成视野昏暗不清,影响操作的正常进行,增加了膀胱损伤的可能,甚至有可能导致腔内碎石失败而不得不改为开放手术取石。
电切镜用于前列腺和膀胱肿瘤电切治疗,它具有进、出水通道,操作时可以一边入水,一边出水,术中视野能一直保持清晰,并且因为镜身较粗,视野较宽阔明亮,如果能够用来配合钬激光进行膀胱、尿道腔内碎石,有望克服钬激光配合膀胱镜碎石时存在的问题。
发明内容
本发明要解决的技术问题是:提供一种能够导引钬激光光纤使其插入电切镜的钬激光光纤导引器。
为解决上述问题采用的技术方案是:钬激光光纤导引器包括具有柔性的导引管和与导引管一端相连的导引器头,导引管内具有光纤孔,导引器头内具有与光纤孔连通的空腔,导引器头端盖有柔性封帽。
进一步的是:导引管由具有柔性的塑料制成,导引器头与导引管由相同塑料一体制成,柔性封帽由乳胶、橡胶或硅胶制成。
本发明要解决的另一技术问题是:提供一种带有电切镜和导引器并能够配合钬激光进行膀胱腔内碎石或尿道内切开的治疗装置。
为解决上述问题采用的技术方案是:带有电切镜和导引器的治疗装置包括电切镜,电切镜包括电切环管和具有密封件的操作柄连接头,电切环管内具有电切环孔,操作柄连接头内具有电切环进入孔,密封件内具有与电切环进入孔连通的密封件孔;还包括上述钬激光光纤导引器,导引管穿过密封件孔、电切环进入孔和电切环孔,导引管与密封件间密封,导引器头位于操作柄连接头外侧。
本发明的有益效果是:电切镜连同导引管从病人尿道进入膀胱。用针在柔性封帽上扎一孔,钬激光光纤即可通过该孔插入导引管内,并从导引管插入病人膀胱,钬激光光纤延伸到结石处即可进行碎石。电切镜具有进水和出水通道,控制进出水,可使得碎石过程中结石碎屑和膀胱壁出血能够被水流带出,避免影响视野,利于保证碎石顺利进行。并且,柔性封帽的弹性能够使其与钬激光光纤间密封,避免水从导引管中漏出,利于保持膀胱充盈,从而同样利于保证视野并保证碎石顺利进行。进行尿道内碎石或内切开时原理相同。
附图说明
图1是钬激光光纤导引器结构图;
图2是电切镜结构图;
图3是带有电切镜和导引器的治疗装置的结构图;
图中标记为:导引管11、导引器头12、光纤孔13、空腔14、柔性封帽15、电切镜2、电切环管21、操作柄连接头22、密封件23、电切环孔24、电切环进入孔25、密封件孔26、水流通道27。
具体实施方式
下面结合附图和具体实施方式对本发明进一步说明。
如图1所示:钬激光光纤导引器包括具有柔性的导引管11和与导引管11一端相连的导引器头12,导引管11内具有光纤孔13,导引器头12内具有与光纤孔13连通的空腔14,导引器头12端盖有柔性封帽15。
将上述钬激光光纤导引器与电切镜结合可得到带有电切镜和导引器的治疗装置,具体如图3所示:带有电切镜和导引器的治疗装置包括电切镜2,电切镜2包括电切环管21和具有密封件23的操作柄连接头22,电切环管21内具有电切环孔24,操作柄连接头22内具有电切环进入孔25,密封件23内具有与电切环进入孔25连通的密封件孔26;还包括上述钬激光光纤导引器,导引管11穿过密封件孔26、电切环进入孔25和电切环孔24,导引管11与密封件23间密封,导引器头12位于操作柄连接头22外侧。
上述电切镜2如图2所示,实际是由现有电切镜拆除了电切环得到,现有电切镜的电切环穿过密封件孔26、电切环进入孔25和电切环孔24,将电切环拆除即可得到图2所示的本发明的电切镜2。
利用本发明进行膀胱腔内碎石的方法如下:电切镜2连同导引管11从病人尿道进入膀胱。用针在柔性封帽15上扎一孔,钬激光光纤即可通过该孔插入导引管11,并从导引管11插入病人膀胱,钬激光光纤延伸到结石处即可进行碎石。电切镜2具有进水和出水通道,即图2所示的水流通道27,控制进出水,可使得碎石过程中结石碎屑和膀胱壁出血能够被水流带出,避免影响视野,利于保证碎石顺利进行。并且,柔性封帽15的弹性能够使其与钬激光光纤间密封,避免水从导引管11中漏出,利于保持膀胱充盈,从而同样利于保证视野并保证碎石顺利进行。
导引管11的柔软程度是能够保证导引管11能够自由弯曲即可,不宜过于柔软,避免影响导引管11的插入。钬激光光纤导引器各部分的材料可以如下:导引管11由具有柔性的塑料制成,导引器头12与导引管11由相同塑料一体制成,柔性封帽15由乳胶、橡胶或硅胶制成。导引管11的外径应与电切镜2本来带有的电切环的外径相同。光纤孔13应能保证能够通过550微米以下直径的光纤。

Claims (3)

1.钬激光光纤导引器,其特征在于:包括具有柔性的导引管(11)和与导引管(11)一端相连的导引器头(12),导引管(11)内具有光纤孔(13),导引器头(12)内具有与光纤孔(13)连通的空腔(14),导引器头(12)端盖有柔性封帽(15)。
2.根据权利要求1所述的钬激光光纤导引器,其特征在于:导引管(11)由具有柔性的塑料制成,导引器头(12)与导引管(11)由相同塑料一体制成,柔性封帽(15)由乳胶、橡胶或硅胶制成。
3.带有电切镜和导引器的治疗装置,包括电切镜(2),电切镜(2)包括电切环管(21)和具有密封件(23)的操作柄连接头(22),电切环管(21)内具有电切环孔(24),操作柄连接头(22)内具有电切环进入孔(25),密封件(23)内具有与电切环进入孔(25)连通的密封件孔(26);其特征在于:包括权利要求1或2所述的钬激光光纤导引器,导引管(11)穿过密封件孔(26)、电切环进入孔(25)和电切环孔(24),导引管(11)与密封件(23)间密封,导引器头(12)位于操作柄连接头(22)外侧。
CN201810150527.0A 2018-02-13 2018-02-13 钬激光光纤导引器及带有电切镜和导引器的治疗装置 Pending CN108158648A (zh)

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Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN200951098Y (zh) * 2006-05-11 2007-09-26 张家华 用于成人前尿道狭窄手术的多功能尿道小电切镜
CN202740110U (zh) * 2012-06-25 2013-02-20 龚永光 一种激光切割镜
CN203244451U (zh) * 2013-04-03 2013-10-23 夏永强 输尿管镜用激光光纤导引及冲水管
CN104138295A (zh) * 2014-07-09 2014-11-12 杨涛 一种多用途激光内窥镜
CN204600683U (zh) * 2015-04-02 2015-09-02 杨帆 一种用于膀胱结石破碎的手术器具
CN209074877U (zh) * 2018-02-13 2019-07-09 石棉县中医医院 钬激光光纤导引器及带有电切镜和导引器的治疗装置

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN200951098Y (zh) * 2006-05-11 2007-09-26 张家华 用于成人前尿道狭窄手术的多功能尿道小电切镜
CN202740110U (zh) * 2012-06-25 2013-02-20 龚永光 一种激光切割镜
CN203244451U (zh) * 2013-04-03 2013-10-23 夏永强 输尿管镜用激光光纤导引及冲水管
CN104138295A (zh) * 2014-07-09 2014-11-12 杨涛 一种多用途激光内窥镜
CN204600683U (zh) * 2015-04-02 2015-09-02 杨帆 一种用于膀胱结石破碎的手术器具
CN209074877U (zh) * 2018-02-13 2019-07-09 石棉县中医医院 钬激光光纤导引器及带有电切镜和导引器的治疗装置

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