CN108577930A - 带有球囊的杯状取石网篮 - Google Patents
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Abstract
本发明涉及医疗器械技术领域,具体是一种内镜逆行胰胆管造影术用带有球囊的杯状取石网篮。本发明装置包括杯状网篮,圈套器,球囊,外套管,内套管;内套管为双腔管,包括管腔Ⅰ和管腔Ⅱ;内套管包裹杯状网篮的金属连杆,内套管的管腔Ⅰ内通过圈套器的连杆,且连杆头端呈倒“L”型,内套管的管腔Ⅱ通过球囊导管,球囊导管为双腔导管,包括管腔Ⅲ和管腔Ⅳ,管腔Ⅲ与球囊导管头端上的球囊相通,管腔Ⅳ通过斑马导丝;圈套器呈“8”字型,分为两个环,其中一个大环与杯状网篮开口相连,一个小环穿过球囊导管。本发明可在肝外胆管结石的内镜治疗等领域广泛推广。
Description
技术领域
本发明涉及医疗器械技术领域,具体是一种内镜逆行胰胆管造影术用带有球囊的杯状取石网篮。
背景技术
肝外胆管结石是我国的一种常见病和多发病,随着内镜技术的不断发展及其附件的不断完善,肝外胆管结石多采用内镜逆行胰胆管造影术(ERCP)取石术。该技术与传统开腹或现代腹腔镜下胆道探查取石手术相比,ERCP取石具有创伤小、安全系数高、恢复快等优点。
目前ERCP取石用的耗材主要是取石球囊及取石网篮,较小的结石往往通过球囊取石,直径1cm以上的结石多采取网篮取石。临床应用的取石网篮均是金属丝编织的网篮,网篮头端和尾端均固定,释放的网篮呈椭圆形或纺锤状,上述取石网篮存在以下不足:1、通过旋转或前后推进网篮使结石通过网篮侧孔进入网篮内,一次套取结石的成功率较低;2、网篮侧孔较大,收紧网篮的过程中,结石可经网篮侧孔溢出,导致结石套取失败;3、胆总管不扩张或结石较大时,网篮释放不开,难以成功套取结石;4、如套取的结石较大,不能通过ERCP取出时,难以将结石从网篮内释放出去,导致ERCP取石手术中进退两难的地步,一旦发生上述情况,只能携带十二指肠镜中转开腹手术,方可取出结石,退出十二指肠镜。
发明内容
为解决现有技术中存在的缺陷,本发明提供一种带有球囊的杯状取石网篮。
为实现上述发明目的,本发明采用如下技术方案:
带有球囊的杯状取石网篮,包括杯状网篮,圈套器,球囊,外套管,内套管;内套管为双腔管,包括管腔Ⅰ和管腔Ⅱ;内套管包裹杯状网篮的金属连杆,内套管的管腔Ⅰ内通过圈套器的连杆,且连杆头端呈倒“L”型,内套管的管腔Ⅱ通过球囊导管,球囊导管为双腔导管,包括管腔Ⅲ和管腔Ⅳ,管腔Ⅲ与球囊导管头端上的球囊相通,管腔Ⅳ通过斑马导丝;圈套器呈“8”字型,分为两个环,其中一个大环与杯状网篮开口相连,一个小环穿过球囊导管。
进一步地,外套管连有外套管手柄,内套管连内套管手柄,套圈器的连杆尾端连有套圈器推进杆及圈套器手柄,球囊导管连接球囊手柄。
进一步地,外套管上有注水孔,球囊手柄上带有注气孔。
进一步地,外套管尾端内壁上有硅胶内衬。
具体地,外套管直径4mm、内套管直径3.5mm,金属连杆直径1.2mm,球囊导管直径1.2mm,管腔Ⅰ和管腔Ⅲ的直径1mm,管腔Ⅱ的直径为1.4mm,管腔Ⅲ的直径0.2mm。
具体地,杯状网篮开口以4个金属环与圈套器相连。
具体地,杯状网篮为镍钛合金网篮。
与现有技术相比,本发明具有以下优点:
1.本发明杯状取石网篮只有尾端一个固定点;
2.取石网篮的头端呈杯口状,通过推进网篮,胆管内结石可轻松进入网篮内;
3.网篮头端设有球囊导管,充盈球囊,可防止结石进入肝内胆管;
4.回拉球囊导管,充盈的球囊可推动结石进入取石网篮内;
5.球囊导管和网篮支撑杆可防止球囊开口的移位;
6.在球囊通过收紧网篮头端的圈套器,形成网篮头部的第二个固定点;
7.取石网篮侧壁金属丝呈网状,侧孔更小,收紧网篮过程中,套取的结石难以经侧孔溢出;
8.使用网篮取出较大结石的同时,网篮前端的球囊可促进胆管内小结石及胆泥的排出,减少取石次数;
9.套取结石不能顺利取出时,可打开网篮并退出结石,不会发生结石嵌顿而网篮不能取出的并发症。
附图说明
图1本发明结构示意图;
图2本发明内、外套管截面图;
图3本发明取石网篮截面图;
图中,1.杯状网篮,2.圈套器,3.球囊,4.外套管,5.内套管,6.杯状网篮的金属连杆, 7.管腔Ⅰ,8.圈套器的连杆,9.管腔Ⅱ,10.球囊导管11.管腔Ⅲ,12.管腔Ⅳ,13.外套管手柄,14.内套管手柄,15.套圈器推进杆,16.圈套器手柄,17.球囊手柄,18.注水孔衬,19.注气孔,20.硅胶内衬,21.金属环,22.斑马导丝。
具体实施方式
以下结合具体实施方式对本发明做进一步说明。
一种带有球囊的杯状取石网篮,包括杯状网篮1,圈套器2,球囊3,外套管4,内套管5;内套管5为双腔管,包括管腔Ⅰ7和管腔Ⅱ9;内套管5包裹杯状网篮的金属连杆6,内套管的管腔Ⅰ7内通过圈套器的连杆8,且圈套器的连杆8头端呈倒“L”型,内套管的管腔Ⅱ9 通过球囊导管10,球囊导管10为双腔导管,包括管腔Ⅲ11、管腔Ⅳ12,球囊导管Ⅲ11与球囊导管头端上的球囊3相通,球囊导管管腔Ⅳ12通过斑马导丝22;圈套器2呈“8”字型,分为两个环,其中一个大环与杯状网篮开口相连,一个小环穿过球囊导管,杯状网篮开口以4 个金属环21与圈套器相连;外套管连有外套管手柄13,外套管上有注水孔18,注入水后润滑内、外套管间隙;内套管连内套管手柄14,圈套器的连杆8尾端连有圈套器推进杆15及圈套器手柄16,球囊导管连接球囊手柄17,球囊手柄17上有注气孔19,可连接球囊注射器,向球囊内通气;外套管直径4mm、内套管直径3.5mm,金属连杆直径1.2mm,球囊导管直径 1.2mm,管腔Ⅰ和管腔Ⅲ的直径1mm,管腔Ⅱ的直径为1.4mm,管腔Ⅲ的直径0.2mm。杯状网篮为镍钛合金网篮。
本发明杯状取石网篮的操作方法:
(1)经外套管注水孔注入生理盐水;
(2)经管腔Ⅳ置入斑马导丝,在导丝引导下经十二指肠镜钳道置入本发明杯状取石网篮,进入胆总管后;
(3)固定内套管手柄,向前推进球囊手柄,球囊导管越过结石进入结石上方肝总管内;
(4)经球囊管注入气体过造影剂充盈气囊;
(5)固定外套管手柄,向前推进内套管手柄,释放杯状取石网篮;
(6)向前推进圈套器手柄,打开圈套器则杯状网篮成完全开口状态;
(7)固定球囊手柄,向胆管内逐步推进外套管手柄或内套管手柄的过程中,杯状取石网篮在胆总管内胆总管末端向肝门部胆管前进;杯状网篮前进的过程中,胆总管内结石可通过网篮口进入网篮内;
(8)固定内套管手柄,通过回拉球囊手柄,球囊在下移的过程中可将结石拖入网篮内;
(9)结石进入杯状网篮口内时,固定内套管手柄,向后拉圈套器及球囊手柄,网篮杯口收紧,成功套取结石;
(10)固定外套管手柄,回拉内套管手柄,收紧取石网篮进而使结石在网篮内固定;
(11)固定圈套器手柄、内套管手柄、球囊手柄及外套管手柄,回拉网篮外套管,进而将结石从胆总管内取出。
释放取出的结石操作方法:
(1)固定外套管手柄,向前推进内套管手柄,使套取结石的杯状网篮离开外套管头端,网篮自行弹开,结石可经网篮侧孔排出;
(2)如结石过大,不能经网篮侧孔排出,此时可固定内套管手柄,向前推进圈套器手柄,张开杯状网篮头端的圈套器,网篮开口重新开放,可将结石从网篮口中排出。
网篮自然位置的恢复操作:
(1)固定内套管手柄,回拉进圈套器手柄,使圈套器及杯状网篮呈收紧状态;
(2)固定内套管手柄,向后拉球囊导管手柄,收回球囊导管;
(3)固定内套管手柄,向前推进外套管手柄,将网篮、球囊导管及网篮的金属连杆收入外套管内。
本发明可在肝外胆管结石的内镜治疗等领域广泛推广。
Claims (7)
1.带有球囊的杯状取石网篮,其特征在于,包括杯状网篮,圈套器,球囊,外套管,内套管;内套管为双腔管,包括管腔Ⅰ和管腔Ⅱ;内套管包裹杯状网篮的金属连杆,内套管的管腔Ⅰ内通过圈套器的连杆,且连杆头端呈倒“L”型,内套管的管腔Ⅱ通过球囊导管,球囊导管为双腔导管,包括管腔Ⅲ、管腔Ⅳ,管腔Ⅲ与球囊导管头端上的球囊相通,管腔Ⅳ通过斑马导丝;圈套器呈“8”字型,分为两个环,其中一个大环与杯状网篮开口相连,一个小环穿过球囊导管。
2.如权利要求1所述的带有球囊的杯状取石网篮,其特征在于,外套管连有外套管手柄,内套管连内套管手柄,套圈器的连杆尾端连有套圈器推进杆及圈套器手柄,球囊导管连接球囊手柄。
3.如权利要求2所述的带有球囊的杯状取石网篮,其特征在于,外套管上有注水孔,球囊手柄上带有注气孔。
4.如权利要求1所述的带有球囊的杯状取石网篮,其特征在于,外套管尾端内壁上有硅胶内衬。
5.如权利要求1所述的带有球囊的杯状取石网篮,其特征在于,外套管直径4mm、内套管直径3.5mm,金属连杆直径1.2mm,球囊导管直径1.2mm,管腔Ⅰ和管腔Ⅲ的直径1mm,管腔Ⅱ的直径为1.4mm,管腔Ⅲ的直径0.2mm。
6.如权利要求1所述的带有球囊的杯状取石网篮,其特征在于,杯状网篮开口以4个金属环与圈套器相连。
7.如权利要求1所述的带有球囊的杯状取石网篮,其特征在于,杯状网篮为镍钛合金网篮。
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