CN108403157B

CN108403157B - Ureteral sheath

Info

Publication number: CN108403157B
Application number: CN201810133234.1A
Authority: CN
Inventors: 饶大庞; 虞海峰
Original assignee: Second Affiliated Hospital and Yuying Childrens Hospital of Wenzhou Medical University
Current assignee: Second Affiliated Hospital and Yuying Childrens Hospital of Wenzhou Medical University
Priority date: 2018-02-09
Filing date: 2018-02-09
Publication date: 2020-07-28
Anticipated expiration: 2038-02-09
Also published as: CN108403157A

Abstract

The invention relates to a ureteral sheath for ureter soft lens operation, which comprises a soft lens outer sheath and a sheath inner core. The ureteral sheath is characterized in that a conical tubular guide head with a small front part and a large rear part is arranged at the front end of a soft lens outer sheath, and an opening is formed in the side surface; the flexible endoscope sheath is provided with a sheath inner core and an outer sheath main body, wherein the main body is also tubular, the front end part of the sheath inner core is in a conical tubular shape and is matched with an inner hole of the guide head and a connecting part, an opposite inserting positioning structure is arranged between the front end of the sheath inner core and the rear end of the guide head, when the upper section of a ureter is narrow and cannot pass through the flexible endoscope sheath in the flexible endoscope operation of the ureter, the flexible endoscope sheath entering along a guide wire remained in the ureter exits from the sheath inner core when the flexible endoscope sheath enters the ureter narrow and cannot enter the ureter narrow, the front end of the flexible endoscope sheath crosses the narrow, the position of the flexible endoscope sheath enables an opening at the front end of the flexible endoscope sheath to be positioned below the narrow part, a bare endoscope reaches an operation field through the narrow section, perfusion liquid continuously enters the operation field through the flexible endoscope during the operation, and the operation field liquid is extended out into the sheath through.

Description

Ureteral sheath

Technical Field

The invention relates to the technical field of medical instruments, in particular to a ureteral sheath for ureteroscope operation.

Background

Before the operation of the ureter soft lens, a ureter sheath is required to be placed in a ureter, and the ureter soft lens enters the ureter sheath to reach the upper section of the ureter or a renal pelvis to carry out the operation. During operation, liquid is continuously filled into the operation field through the flexible ureteroscope, and meanwhile, the liquid in the operation field is continuously discharged out of the body through the ureteral sheath, so that the operation field is kept clear. If the upper ureter is narrow and cannot pass through the sheath, only two schemes can be adopted: 1. the bare endoscope reaches the operative field through ureterstenosis for operation, the liquid in the operative field can not be smoothly discharged out of the body through the sheath, the operative field is unclear, the operation is influenced, and even part of patients can not discharge the liquid in the operative field to cause renal pelvis high pressure, thereby causing serious complications such as urogenesis infection, perirenal hematoma and the like. 2. D-J tube is retained in the ureter, the operation is stopped, and the operation is performed again after 2 weeks, thereby greatly improving the hospitalization cost of the patient and increasing the workload of the hospital. How to keep the operation field clear to carry out the soft ureteroscope operation and reduce the operation complication and the operation cost and the hospital workload under the condition that the upper ureter segment is narrow and can not pass through the sheath is a difficult problem concerned by the urinary surgeons at present.

Disclosure of Invention

The invention aims to provide a ureteral sheath for ureteroscope operation, which is suitable for the operation of the upper ureter or renal pelvis.

In order to solve the technical problem, the invention discloses a ureteral sheath which is characterized in that: the soft endoscope sheath comprises a soft endoscope sheath and a sheath inner core, wherein the soft endoscope sheath comprises a sheath main body and a guide head arranged at the front end of the sheath main body, the sheath main body is a tubular component, the guide head is in a conical tube shape with a small front part and a large rear part, a section of tube wall at the front end part of the sheath main body extends to form a connecting part which is connected with the guide head into a whole, and meanwhile, an opening is formed on the side surface of the connecting part; the main body of the sheath inner core is also tubular, an axial through hole matched with the guide wire is formed in the center of the main body, the outer diameter of the main body of the sheath is in clearance fit with the inner aperture of the main body of the outer sheath, the front end of the sheath inner core is conical tubular and is matched with the inner hole of the guide head and the connecting part, and an opposite insertion positioning structure is arranged between the front end of the sheath inner core and the rear end of the guide head.

As a further arrangement of the invention, the front end of the sheath inner core is provided with a bump or is arranged in a zigzag manner, and the inner hole wall of the guide head is provided with a corresponding groove or a zigzag groove to form the opposite insertion positioning structure.

Compared with the prior art, the ureteral sheath is provided with the conical tubular guide head with a small front part and a large rear part at the front end of the soft lens sheath, and an opening is formed on the side surface; the flexible endoscope sheath is also provided with a sheath inner core which is also tubular in main body and conical tubular in front end part and is in clearance fit with the inner aperture of the sheath main body, the front end part of the sheath inner core is conical tubular and is matched with the inner aperture of the guide head and the connecting part, an opposite insertion positioning structure is arranged between the front end of the sheath inner core and the rear end of the guide head, when the upper section of a ureter is narrow and can not pass through the flexible endoscope sheath in the flexible endoscope operation of the ureter, the flexible endoscope sheath entering along a guide wire remained in the ureter is withdrawn from the sheath inner core until the ureter is narrow and can not continue to enter the sheath, the front end of the flexible endoscope sheath passes through the narrow part, and the position of the flexible endoscope sheath enables an opening at the front end of the flexible endoscope sheath to be positioned. During operation, the perfusion liquid continuously enters the operation field through the soft lens, and the operation field liquid is discharged into the sheath through the overhanging catheter to keep the operation field clear.

The technical scheme of the invention is further specifically described below by combining the drawings and the embodiment.

Drawings

FIG. 1 is a schematic perspective view of an embodiment of the present invention;

FIG. 2 is a schematic perspective view of an embodiment of a soft lens sheath according to the present invention;

FIG. 3 is a front view of an embodiment of the soft lens sheath of the present invention;

FIG. 4 is a cross-sectional view of the structure of FIG. 3A-A;

FIG. 5 is an enlarged view of a portion of FIG. 4I;

FIG. 6 is a schematic perspective view of an embodiment of the sheath core of the present invention;

FIG. 7 is a front view of an embodiment of the sheath core of the present invention;

FIG. 8 is an enlarged view of a portion of FIG. 7 II;

FIG. 9 is a cross-sectional view of the structure of FIGS. 7B-B;

fig. 10 is a partially enlarged view of the portion of fig. 9 III.

Detailed Description

As shown in fig. 1 to 10, the ureteral sheath comprises a flexible endoscope sheath 1 and a sheath inner core 2, the flexible endoscope sheath 1 comprises a sheath main body 101 and a guide head 102 arranged at the front end of the sheath main body 101, the sheath main body 101 is a tubular member, the diameter of the sheath main body 101 of the flexible endoscope sheath 1 can be the same as that of an existing flexible endoscope sheath, the flexible endoscope sheath can be matched with a flexible ureteral endoscope and can be made of the same material, the guide head 102 is in a tapered tubular shape with a small front part and a large back part, the tip is forward, the diameter of the back end is preferably smaller than that of the sheath main body 101, a section of the tubular wall of the front end part of the sheath main body 101 (preferably at a proper inclination angle) extends to form a connecting part 103 which is connected with the guide head. The main part of sheath inner core 2 is the tubulose equally, and the center is equipped with and cooperates with the seal wire axial through-hole and constitutes seal wire hole 201, and external diameter and sheath main part 101 internal aperture clearance fit, the front end of sheath inner core 2 is the toper tubulose, with guide head 102 hole and connecting portion 103 match, the front end of sheath inner core 2 with be equipped with between the guide head 102 rear end and to inserting location structure, be favorable to after having set up to inserting location structure the front end of sheath inner core 2 with both are inserted to combining, are difficult for breaking away from and rotatory guide head 102 rear end.

The opposite insertion positioning structure can be in various forms, in this embodiment, a protrusion 202 is disposed at the front end of the sheath core 2, and a corresponding groove is disposed on the inner hole wall of the guide head 102 to form the opposite insertion positioning structure.

Or the front end of the sheath inner core 2 is serrated, and the inner hole wall of the guide head 102 is provided with corresponding serrated grooves to form the opposite insertion positioning structure.

The ureteral sheath of the invention has the following using process:

in the ureter soft lens operation, firstly, a safety guide wire is arranged in the ureter, the head end of the guide wire is positioned in the renal pelvis, and the tail end of the guide wire is exposed out of the urethral orifice. The sheath inner core 2 is penetrated into the soft lens outer sheath 1, and the convex block 202 at the front end of the sheath inner core 2 is matched with the groove of the inner hole wall of the guide head 102 to form a whole. The tail end of the safety guide wire passes through the guide head 102 to enter the guide wire hole 201 and then comes out from the far end of the soft lens outer sheath 1, then the whole soft lens outer sheath 1 enters the upper end of the ureter along the guide wire, when the soft lens outer sheath 1 cannot continue to enter the sheath from the ureter stenosis, the sheath inner core 2 is withdrawn, and the guide head 102 of the soft lens outer sheath 1 passes through the stenosis, so that the opening at the front end of the soft lens outer sheath 1 is positioned below the ureter stenosis. The ureter soft lens reaches the operation field through the narrow section with the naked lens, and the soft lens sheath 1 is adjusted through retreating, so that the guide head 102 section crosses the narrow section ureter, and the liquid above the narrow section is drained to the lower part of the narrow section. During operation, the perfusion liquid continuously enters the operation field through the soft lens, and the operation field liquid is discharged into the sheath through the guide head 102 to keep the operation field clear.

Claims

1. A ureteral sheath, comprising: the soft endoscope sheath comprises a soft endoscope sheath and a sheath inner core, wherein the soft endoscope sheath comprises a sheath main body and a guide head arranged at the front end of the sheath main body, the sheath main body is a tubular component, the guide head is in a conical tube shape with a small front part and a large rear part, a section of tube wall at the front end part of the sheath main body extends to form a connecting part which is connected with the guide head into a whole, and meanwhile, an opening is formed on the side surface of the connecting part; the main body of the sheath inner core is also tubular, an axial through hole matched with the guide wire is formed in the center of the main body, the outer diameter of the main body of the sheath is in clearance fit with the inner aperture of the main body of the outer sheath, the front end of the sheath inner core is conical tubular and is matched with the inner hole of the guide head and the connecting part, and an opposite insertion positioning structure is arranged between the front end of the sheath inner core and the rear end of the guide head.

2. The ureteral sheath of claim 1, wherein: the front end of the sheath inner core is provided with a convex block, and the inner hole wall of the guide head is provided with a corresponding groove to form the opposite insertion positioning structure.

3. The ureteral sheath of claim 1, wherein: the front end of the sheath inner core is in a sawtooth shape, and the inner hole wall of the guide head is provided with corresponding sawtooth-shaped grooves to form the opposite insertion positioning structure.