CN108992144B - Dilating sheath and endoscope with dilating sheath - Google Patents
Dilating sheath and endoscope with dilating sheath Download PDFInfo
- Publication number
- CN108992144B CN108992144B CN201810968916.4A CN201810968916A CN108992144B CN 108992144 B CN108992144 B CN 108992144B CN 201810968916 A CN201810968916 A CN 201810968916A CN 108992144 B CN108992144 B CN 108992144B
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- joint
- needle tube
- expansion
- branch pipe
- negative pressure
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- 230000000916 dilatatory effect Effects 0.000 title claims abstract description 45
- 238000005070 sampling Methods 0.000 claims abstract description 97
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 claims description 24
- 238000002347 injection Methods 0.000 claims description 14
- 239000007924 injection Substances 0.000 claims description 14
- 238000007789 sealing Methods 0.000 claims description 7
- 230000007704 transition Effects 0.000 claims description 3
- 238000000034 method Methods 0.000 description 15
- 230000001575 pathological effect Effects 0.000 description 13
- 230000008569 process Effects 0.000 description 11
- 239000000523 sample Substances 0.000 description 9
- 239000000835 fiber Substances 0.000 description 7
- 229910052689 Holmium Inorganic materials 0.000 description 6
- 210000004204 blood vessel Anatomy 0.000 description 6
- KJZYNXUDTRRSPN-UHFFFAOYSA-N holmium atom Chemical compound [Ho] KJZYNXUDTRRSPN-UHFFFAOYSA-N 0.000 description 6
- 210000003734 kidney Anatomy 0.000 description 6
- 208000032843 Hemorrhage Diseases 0.000 description 4
- 238000001356 surgical procedure Methods 0.000 description 4
- 230000003902 lesion Effects 0.000 description 3
- 230000001225 therapeutic effect Effects 0.000 description 3
- 230000000007 visual effect Effects 0.000 description 3
- 230000009286 beneficial effect Effects 0.000 description 2
- 230000000740 bleeding effect Effects 0.000 description 2
- 238000013532 laser treatment Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 238000011084 recovery Methods 0.000 description 2
- 238000002604 ultrasonography Methods 0.000 description 2
- 208000000913 Kidney Calculi Diseases 0.000 description 1
- 206010029148 Nephrolithiasis Diseases 0.000 description 1
- 238000001574 biopsy Methods 0.000 description 1
- 230000006835 compression Effects 0.000 description 1
- 238000007906 compression Methods 0.000 description 1
- 230000008878 coupling Effects 0.000 description 1
- 238000010168 coupling process Methods 0.000 description 1
- 238000005859 coupling reaction Methods 0.000 description 1
- 230000006378 damage Effects 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 238000002682 general surgery Methods 0.000 description 1
- 238000002324 minimally invasive surgery Methods 0.000 description 1
- 230000007170 pathology Effects 0.000 description 1
- 238000004904 shortening Methods 0.000 description 1
- 239000000243 solution Substances 0.000 description 1
- 239000000126 substance Substances 0.000 description 1
- 210000000115 thoracic cavity Anatomy 0.000 description 1
- 238000011282 treatment Methods 0.000 description 1
- 238000012285 ultrasound imaging Methods 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
- A61B1/015—Control of fluid supply or evacuation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
- A61B1/018—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/06—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
- A61B1/0661—Endoscope light sources
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/06—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
- A61B1/07—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements using light-conductive means, e.g. optical fibres
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/12—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with cooling or rinsing arrangements
- A61B1/126—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with cooling or rinsing arrangements provided with means for cleaning in-use
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
- A61B10/02—Instruments for taking cell samples or for biopsy
- A61B10/04—Endoscopic instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B17/3439—Cannulas with means for changing the inner diameter of the cannula, e.g. expandable
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
- A61B10/02—Instruments for taking cell samples or for biopsy
- A61B10/04—Endoscopic instruments
- A61B2010/045—Needles
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/00296—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means mounted on an endoscope
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
- A61B2017/3413—Needle locating or guiding means guided by ultrasound
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B2017/3445—Cannulas used as instrument channel for multiple instruments
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Animal Behavior & Ethology (AREA)
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- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Pathology (AREA)
- Radiology & Medical Imaging (AREA)
- Physics & Mathematics (AREA)
- Biophysics (AREA)
- Optics & Photonics (AREA)
- Endoscopes (AREA)
Abstract
The invention discloses an expansion sheath and an endoscope with the expansion sheath, which comprises an expansion sheath handle and an expansion pipe connected with the front end of the expansion sheath handle, wherein the expansion pipe is a multi-stage expansion pipe, the multi-stage expansion pipe comprises a plurality of expansion branch pipes with the outer diameters coaxially sleeved in a descending order, each expansion branch pipe is in axial sliding fit with the expansion branch pipe adjacent to the expansion branch pipe and the outer diameter of which is smaller than the outer diameter of the expansion branch pipe, and the length of the expansion branch pipe with the large outer diameter is smaller than the length of the expansion branch pipe with the small outer diameter. The dilating sheath and the endoscope have simple structure and convenient use in cooperation, and the endoscope handle can be combined with the puncture needle tube and the puncture sampling needle tube according to the operation requirement, so that the puncture is ensured to be smooth.
Description
Technical Field
The invention relates to the technical field of minimally invasive medical instruments, in particular to an expanding sheath and an endoscope with the same.
Background
At present, the minimally invasive surgery has the advantages of reducing pain of patients, being beneficial to recovery, having beautiful appearance, shortening hospitalization time, reducing cost and the like, and has been widely applied to departments such as urology surgery, orthopaedics, gynecology, general surgery, thoracic surgery, pathology, ophthalmology and the like. At present, kidney stones are treated in the field of urology surgery, percutaneous nephrolithotomy is widely used, and the percutaneous nephrolithotomy has the advantages of small wound, small damage to kidneys and surrounding tissues, light pain, short treatment period, immediate effect, quick recovery and the like.
When the percutaneous nephroscope operation is clinically performed by puncturing the kidney, an operator judges the punctured part by touching or predicting the depth under the guidance of ultrasound, CT and the like, and the methods are blind and time-consuming, and have errors and are easy to cause the following problems.
1) The puncture process can not be monitored in real time, and the blood vessel is easy to puncture to cause bleeding, so that the operation can not be performed;
2) After the puncture is finished, the guide wire is placed into the kidney through the puncture needle tube, then the expanding sheath is expanded along the guide wire, and the advancing position of the expanding sheath cannot be observed during expansion, so that intrarenal hemorrhage is easily caused, and medical accidents or operation cannot be continued;
3) In the percutaneous kidney operation process, the intrarenal calculus is found to be hard, a lithotripter with high lithotripter efficiency is needed, however, the diameter of the lithotripter is larger as the lithotripter is higher, when the diameter of the lithotripter is too large, the implanted expanding sheath cavity is difficult to contain, a guide wire is needed to be penetrated again, the expanding sheath is withdrawn, the larger expanding sheath of the cavity is re-implanted, the operation is complicated, and the operation time is increased;
4) Complications are caused by excessive internal pressure of the kidney during percutaneous kidney surgery.
Disclosure of Invention
The invention aims to solve the defects of the background technology and provide an expanding sheath and an endoscope with the expanding sheath, wherein the expanding sheath can accurately puncture and monitor the puncture position in real time and ensure smooth puncture.
In order to achieve the purpose, the expansion sheath designed by the invention comprises an expansion sheath handle and an expansion tube connected with the front end of the expansion sheath handle, and is characterized in that: the expansion pipe is a multi-stage expansion pipe, the multi-stage expansion pipe comprises a plurality of expansion branch pipes with the outer diameters being coaxially sleeved in a descending order, each expansion branch pipe is in axial sliding fit with the adjacent expansion branch pipe, and the length of the expansion branch pipe with the large outer diameter is smaller than that of the expansion branch pipe with the small outer diameter.
Further, the endoscope with the dilating sheath comprises an endoscope handle, wherein a puncture sampling needle tube is inserted into the dilating sheath handle and the dilating tube; the rear end of the puncture sampling needle tube is fixedly connected with a puncture sampling needle tube joint, and a shaft hole coaxially communicated with the puncture sampling needle tube is axially formed in the puncture sampling needle tube joint; the outer surface of the puncture sampling needle tube joint is matched with the dilating sheath handle, and the rear end of the puncture sampling needle tube joint is fixedly connected with the endoscope handle; the endoscope handle is provided with an image lighting device channel which is coaxially communicated with the puncture sampling needle tube connector along the axial direction of the endoscope handle, and an image lighting device connector is arranged at the port of the image lighting device channel.
Furthermore, the outer surface of the front end of each expansion branch pipe is conical, and the conical surface is provided with a water outlet.
Further, the rear end of each expansion branch pipe is fixedly connected with a branch pipe joint respectively, the branch pipe joints are sequentially and axially overlapped and movably connected into an integral multi-stage expansion pipe joint, and the multi-stage expansion pipe joint is connected with the expansion sheath handle.
Further, one end of each branch pipe joint is provided with a branch pipe joint positioning ring along the axial direction of the branch pipe joint, and the other end of each branch pipe joint is provided with an expansion branch pipe fixing hole and a branch pipe joint positioning groove corresponding to the branch pipe joint positioning ring along the central axial direction of the branch pipe joint; the rear end of each expansion branch pipe is inserted into an expansion branch pipe fixing hole of the corresponding branch pipe joint; the branch pipe joint positioning ring of each branch pipe joint is inserted into the branch pipe joint positioning groove of the adjacent branch pipe joint; the front end of the expansion sheath handle is provided with a branch pipe joint positioning hole along the axial direction of the front end of the expansion sheath handle, and a branch pipe joint positioning ring of the last section of branch pipe joint of the multi-stage expansion pipe joint is inserted into the branch pipe joint positioning hole, so that the multi-stage expansion pipe joint is connected with the expansion sheath handle.
Further, a puncture sampling channel which is communicated from front to back is arranged in the expanding sheath handle along the axial direction of the expanding sheath handle; the rear end of the dilating sheath handle is coaxially connected with a puncture sampling needle tube positioning joint.
Furthermore, the rear end of the dilating sheath handle connected with the puncture sampling needle tube positioning joint is provided with external threads, the puncture sampling needle tube positioning joint consists of a threaded sleeve and a rubber ring, and a dilating sheath handle positioning hole, a rubber ring positioning hole and a puncture sampling needle tube joint positioning hole are sequentially formed in the threaded sleeve from front to back along the axial direction of the threaded sleeve; an internal thread is arranged on the hole wall of the expanding sheath handle positioning hole and is matched with an external thread at the rear end of the expanding sheath handle; the utility model discloses a puncture sampling needle tube, including the rubber circle, the rubber circle locating hole is equipped with in the rubber circle locating hole can with puncture sampling needle tube surface complex the limit mesa of rubber circle compressed position is equipped with in the screw sleeve, the front end of rubber circle with the rear end contact of expanding sheath handle, the rear end of rubber circle with limit mesa contact.
Still further, puncture sample needle tubing connects locating hole for being close to rubber circle locating hole one end aperture little, keep away from the big bell mouth of rubber circle locating hole one end aperture, the aperture of rubber circle locating hole is greater than puncture sample needle tubing connects the aperture that the locating hole is close to rubber circle locating hole one end, the transition face of rubber circle locating hole and puncture sample needle tubing connects the locating hole is spacing mesa.
Further, the side part of the dilating sheath handle is connected with a negative pressure connecting pipe communicated with the puncture sampling channel, and the end part of the negative pressure connecting pipe is fixedly connected with a negative pressure suction adjusting joint.
Still further, negative pressure suction adjusting joint includes the negative pressure suction sleeve of coaxial fixed intercommunication with the negative pressure connecting pipe, the negative pressure suction sleeve the surface open with the negative pressure suction adjusting port of negative pressure connecting pipe intercommunication, coaxial cover is equipped with the negative pressure suction adjusting sleeve on the negative pressure suction sleeve, open on the negative pressure suction adjusting sleeve with the negative pressure suction adjusting port that the negative pressure suction adjusting port corresponds is adjusted the mouth, the coaxial fixed intercommunication of negative pressure suction sleeve has the negative pressure coupling.
Still further, the circumferential surface of negative pressure suction sleeve is opened there is the annular, the annular internal fixation has negative pressure suction sleeve sealing washer, negative pressure suction sleeve sealing washer with negative pressure suction adjusting sleeve's internal surface contact.
Further, the puncture sampling needle tube joint comprises a needle tube joint handheld seat, one side of the needle tube joint handheld seat is coaxially and fixedly connected with a needle tube joint positioning seat matched with a puncture sampling needle tube joint positioning hole, one end of the puncture sampling needle tube, which is far away from the multistage expansion tube, is coaxially fixed in the needle tube joint positioning seat, the other side of the needle tube joint handheld seat is coaxially fixed with a needle tube joint fixing cylinder, the surface of the needle tube joint fixing cylinder is provided with threads, one end of the endoscope handle is axially provided with an endoscope handle threaded hole, the needle tube joint fixing cylinder is in threaded connection with the endoscope handle threaded hole, and the image lighting device channel is coaxially communicated with the endoscope handle threaded hole.
Preferably, an ultrasonic developing groove is arranged on the surface of one end of the puncture sampling needle tube, which is close to the multistage expansion tube, and a sampling inverted hook opening is formed in the surface.
Furthermore, a water injection channel and an instrument channel which are communicated with the image lighting device channel are also arranged in the endoscope handle, and the endoscope handle is fixedly connected with a water injection joint which is coaxially communicated with the water injection channel and an instrument joint which is coaxially communicated with the instrument channel.
The beneficial effects of the invention are as follows:
1. The endoscope provided by the invention has a simple structure and is convenient to use. According to the operation requirement, the endoscope handle can be combined with the puncture needle tube and the puncture sampling needle tube. When the endoscope handle and the puncture needle tube are combined for use, the image lighting device is inserted into the needle tube, the depth of the image lighting device inserted into the needle tube is adjusted to adjust the observation range, water is injected from the water injection joint, water flow enters the human body cavity through the needle tube and rushes out of a shielding object in front of the lens, and the wide visual field and clear image are ensured.
2. The endoscope can be used for probing pathological tissues in a cavity and diagnosing the pathological tissues. The ultrasonic developing groove around the needle tube tip has a plurality of sharp angles to strengthen the reflection of sound waves in the puncturing process, the position of the needle point can be clearly judged through ultrasonic energy, whether the needle point touches a blood vessel or not can be seen in real time through the image lighting device in the puncturing process, the blood vessel is prevented from being punctured in the puncturing process, the blood vessel is prevented from being greatly bleeding, when the detected pathological tissue needs to be sampled and biopsied, the method is characterized in that only the one-stage dilating tube of the multi-stage dilating tube is pushed into a human body cavity along the puncture tube, the puncture needle tube is withdrawn, the image lighting device is taken out from the puncture needle tube, the puncture sampling needle tube is combined with the endoscope handle, the image lighting device is inserted into the puncture sampling needle tube, the combined puncture sampling needle tube directly enters the human body cavity through the multi-stage dilating tube without secondary puncture, and the position to be sampled is found through the image lighting device for sampling.
3. After the pathological tissue is probed and diagnosed in the human body cavity, when the pathological tissue is smashed and treated, a doctor pushes the multi-stage expansion tube to the puncture opening, the conical tube at the front end of the one-stage expansion tube is utilized to expand the puncture opening, the one-stage expansion tube enters the human body cavity, the position of the one-stage expansion tube entering the human body cavity is observed through the image lighting device in the puncture needle tube, after the position is determined, the relative position of the puncture needle and the pathological tissue is observed and adjusted through the image lighting device, and the rubber ring holding needle tube is adjusted through the puncture sampling needle tube positioning joint on the expansion sheath handle. The holmium laser fiber is inserted through the instrument connector, enters the human body cavity through the needle tube, and heat generated by holmium laser work is taken away through water injected into the human body cavity and flows into the cavity of the needle tube through the water outlet holes around the conical end of the primary expansion tube and flows out of the negative pressure connecting tube.
4. In order to prevent the excessive pressure in the cavity in the operation process, the negative pressure aspirator can be connected to control the pressure in the cavity through the negative pressure suction adjusting joint, and meanwhile, the lesion tissues crushed by holmium laser can be sucked out of the body through the negative pressure connecting pipe.
5. In the operation process, if the pathological tissues are difficult to crush, large-size and high-power crushing instruments need to be replaced, and a larger working channel is also established. At this time, the secondary expansion inner cavity is used as a working channel, a branch pipe joint of the secondary expansion pipe is connected with an expansion pipe handle, a large-size crushing device and an endoscope are selected to enter the human body cavity through the secondary expansion pipe cavity (if a larger working channel is needed in operation, the tertiary expansion pipe and the subsequent multistage expansion pipe are pushed in according to the method). Pushing the secondary expansion tube to the puncture along the primary expansion tube, expanding the puncture by using a conical tube at the front end of the secondary expansion tube, enabling the secondary expansion tube to enter the human body cavity, detaching the primary expansion tube connector from the expansion tube handle, and taking out the secondary expansion tube connector from the human body along the tube cavity of the secondary expansion tube.
Drawings
FIG. 1 is a perspective view of an expanding sheath of the present invention;
FIG. 2 is a front view of an expanding sheath of the present invention;
FIG. 3 is a right side view of the dilating sheath of the present invention;
FIG. 4 is a cross-sectional view A-A of FIG. 3;
FIG. 5 is a cross-sectional view of the dilating sheath handle of FIG. 4;
FIG. 6 is a cross-sectional view of the connection of the extension tube to the sub-tube fitting of FIG. 4;
FIG. 7 is a perspective view of the connection of the puncture and sampling needle cannula to the puncture and sampling needle cannula connector in the present invention;
FIG. 8 is a front view of the connection of the puncture and sampling needle cannula and the puncture and sampling needle cannula connector in the present invention;
FIG. 9 is a cross-sectional view B-B of FIG. 8;
FIG. 10 is a front view of an endoscope attachment structure of the present invention;
FIG. 11 is a perspective view of an endoscope handle of the present invention;
FIG. 12 is a front view of an endoscope attachment structure of the present invention;
FIG. 13 is a cross-sectional view of C-C of FIG. 12;
FIG. 14 is a cross-sectional view of the endoscope handle of FIG. 13;
Wherein, 100-expanding sheath handle, 101-multi-stage expanding tube, 102-expanding branch tube, 103-branch tube joint (103.1-branch tube joint positioning ring, 103.2-expanding branch tube fixing hole, 103.3-branch tube joint positioning groove), 104-multi-stage expanding tube joint, 105-water outlet hole, 106-branch tube joint positioning hole, 107-puncture sampling channel, 108-puncture sampling needle tube positioning joint, 109-needle tube joint threaded sleeve, 110-rubber ring, 111-limit table top, 112-negative pressure connecting tube, 113-negative pressure suction adjusting joint (113.1-negative pressure suction sleeve, 113.2-negative pressure suction adjusting sleeve, 113.3-negative pressure tube joint), 114-negative pressure suction adjusting port, 115-negative pressure suction adjusting port, 116-puncture sampling needle tube, 117-puncture sampling needle tube joint (117.1-needle tube joint handheld seat, 117.2-needle tube joint positioning seat, 117.3-joint fixing cylinder), 118-negative pressure suction sleeve sealing ring, 119-expanding sheath handle positioning hole, 120-rubber ring positioning hole, 121-puncture needle tube positioning hole, 123-ultrasonic needle tube, 122-puncture needle tube positioning hole, 122-puncture needle tube, 124-puncture needle tube positioning hole;
200-endoscope handle, 201-image illuminator channel, 202-image illuminator connector, 203-endoscope handle threaded hole, 204-water injection channel, 205-instrument channel, 206-water injection connector, 207-instrument connector.
Detailed Description
The invention will now be described in further detail with reference to the drawings and to specific examples.
The expanding sheath shown in fig. 1-6 comprises an expanding sheath handle 100 and an expanding tube connected with the front end of the expanding sheath handle 100, the expanding tube is a multi-stage expanding tube 101, the multi-stage expanding tube 101 comprises a plurality of expanding branch tubes 102 (three expanding branch tubes are adopted in the invention) which are coaxially sleeved and arranged in the order from small to large in outer diameter, each expanding branch tube 102 is axially and slidably matched with the expanding branch tube 102 adjacent to the expanding branch tube and the outer diameter of which is smaller than that of the expanding branch tube, and the length of the expanding branch tube 102 with the large outer diameter is smaller than that of the expanding branch tube with the small outer diameter. One end of each expansion branch pipe 102 is fixedly connected with a branch pipe joint 103, one end of each branch pipe joint 103 is axially provided with a branch pipe joint positioning ring 103.1, and the other end of each branch pipe joint 103 is axially provided with an expansion branch pipe fixing hole 103.2 and a branch pipe joint positioning groove 103.3 corresponding to the branch pipe joint positioning ring 103.1; one end of each expansion branch pipe 102 is inserted into an expansion branch pipe fixing hole 103.2 of the corresponding branch pipe joint 103; the branch pipe joint positioning ring 103.1 of each branch pipe joint 103 is inserted into the branch pipe joint positioning groove 103.3 of the adjacent branch pipe joint 103. The branch pipe joints 103 are sequentially and movably connected with each other to form an integral multi-stage expansion pipe joint 104, the front end of the expansion sheath handle 100 is axially provided with a branch pipe joint positioning hole 106, and a branch pipe joint positioning ring 103.1 at the connecting end of the multi-stage expansion pipe joint 104 and the expansion sheath handle 100 is inserted into the branch pipe joint positioning hole 106. The outer surface of the other end of each expansion branch pipe 102 is conical, and the conical surface is provided with a water outlet 105.
As shown in fig. 7-14, the dilating sheath handle 100 of the dilating sheath and the dilating catheter are inserted with a puncture sampling needle tube 116 (the surface of one end of the puncture sampling needle tube 116, which is close to the multi-stage dilating catheter 101, is provided with an ultrasonic developing groove 122 and a sampling barb 124, which is convenient for developing and puncture sampling); the rear end fixedly connected with puncture sample needle tubing 116 punctures sample needle tubing and connects 117, puncture sample needle tubing connects 117 includes needle tubing connects handheld seat 117.1, the coaxial fixedly connected with of one side of needle tubing connects handheld seat 117.1 with puncture sample needle tubing connects locating hole 121 complex needle tubing connects locating seat 117.2, puncture sample needle tubing 116 keeps away from the coaxial fixed in needle tubing connects locating seat 117.2 of one end of multistage expansion pipe 101, the opposite side coaxial fixed with needle tubing connects fixed cylinder 117.3 of needle tubing connects handheld seat 117.1, the surface of needle tubing connects fixed cylinder 117.3 is equipped with the screw thread, one side of endoscope handle 200 is opened along its axial and is had endoscope handle screw hole 203, needle tubing connects fixed cylinder 117.3 threaded connection in endoscope handle screw hole 203, image lighting device passageway 201 and the coaxial intercommunication of endoscope handle screw hole 203.
The puncture sampling needle tube joint 117 is internally provided with a shaft hole which is coaxially communicated with the puncture sampling needle tube 116 along the axial direction; the outer surface of the puncture sampling needle tube joint 117 is matched with the dilating sheath handle 100, and the rear end of the puncture sampling needle tube joint 117 is fixedly connected with the endoscope handle 200; the endoscope handle 200 is provided with an image illuminator channel 201 coaxially communicating with the puncture sampling needle tube joint 117 along the axial direction thereof, and an image illuminator joint 202 is provided at the port of the image illuminator channel 201. A puncture sampling channel 107 which penetrates from front to back is arranged in the expanding sheath handle 100 along the axial direction; the rear end of the dilating sheath handle 100 is coaxially connected with a puncture sampling needle tube positioning joint 108. The rear end of the dilating sheath handle 100 connected with the puncture sampling needle tube positioning joint 108 is provided with external threads, the puncture sampling needle tube positioning joint 108 consists of a threaded sleeve 109 and a rubber ring 110, and a dilating sheath handle positioning hole 119, a rubber ring positioning hole 120 and a puncture sampling needle tube joint positioning hole 121 are sequentially formed in the threaded sleeve 109 from front to back along the axial direction; the puncture sampling needle tube joint positioning hole 121 is a conical hole with a small aperture near one end of the rubber ring positioning hole 120 and a large aperture far away from one end of the rubber ring positioning hole 120, and the aperture of the rubber ring positioning hole 120 is larger than the aperture near one end of the puncture sampling needle tube joint positioning hole 121 near the rubber ring positioning hole 120. The hole wall of the expanding sheath handle positioning hole 119 is provided with internal threads which are matched with external threads at the rear end of the expanding sheath handle 100; the rubber ring positioning hole 120 is internally provided with a rubber ring 110 matched with the surface of the puncture sampling needle tube 116, the threaded sleeve 109 is internally provided with a limiting table top 111 for limiting the compression position of the rubber ring 110 (the transition surface of the rubber ring positioning hole 120 and the puncture sampling needle tube joint positioning hole 121 is a limiting table top 111), the front end of the rubber ring 110 is contacted with the rear end of the dilating sheath handle 100, and the rear end of the rubber ring 110 is contacted with the limiting table top 111.
The side of the dilating sheath handle 100 is connected with a negative pressure connecting pipe 112 communicated with the puncture sampling channel 107, and the end part of the negative pressure connecting pipe 112 is fixedly connected with a negative pressure suction adjusting joint 113. The negative pressure suction adjusting joint 113 comprises a negative pressure suction sleeve 113.1 which is coaxially and fixedly communicated with the negative pressure connecting pipe 112, a negative pressure suction adjusting port 114 which is communicated with the negative pressure connecting pipe 112 is formed in the surface of the negative pressure suction sleeve 113.1, a negative pressure suction adjusting sleeve 113.2 is coaxially sleeved on the negative pressure suction sleeve 113.1, a negative pressure suction adjusting through port 115 which corresponds to the negative pressure suction adjusting port 114 is formed in the negative pressure suction adjusting sleeve 113.2, and a negative pressure pipe joint 113.3 is coaxially and fixedly communicated with the negative pressure suction sleeve 113.1. The circumferential surface of the negative pressure suction sleeve 113.1 is provided with a ring groove, a negative pressure suction sleeve sealing ring 118 is fixed in the ring groove, and the negative pressure suction sleeve sealing ring 118 is contacted with the inner surface of the negative pressure suction adjusting sleeve 113.2.
The endoscope handle 200 is also internally provided with a water injection channel 204 and an instrument channel 205 which are communicated with the image lighting device channel 201, and the endoscope handle 200 is fixedly connected with a water injection joint 206 which is coaxially communicated with the water injection channel 204 and an instrument joint 207 which is coaxially communicated with the instrument channel 205.
In the invention, the combination structure of the expanding sheath and the endoscope is simple and the use is convenient. Has two functions of visual puncture sampling and laser treatment:
Visual puncture sampling: according to the operation requirement, can insert puncture sampling needle tube 116 from endoscope handle 200, when endoscope handle 200 and puncture sampling needle tube 116 make up the use, image lighting device (such as optic fibre mirror) inserts puncture sampling needle tube 116, and it is clear to pass through the overshoot field of vision from water injection joint 206 water injection, can survey the intracavity pathological tissue, diagnose pathological tissue, in the time of the position of the human tissue that puncture sampling needle tube 116 pointed end was located, the poor judgement of direction, ultrasound imaging groove 122 around the needle tube pointed end has a plurality of closed angles can strengthen the sound wave reflection, can clearly judge the position that the needle point is located through the ultrasound energy, can see through image lighting device (such as optic fibre mirror) in real time that the needle point has the touching to the blood vessel in the puncture process, avoid puncture blood vessel in the puncture process to avoid the massive hemorrhage, when the pathological tissue that the probe is surveyed needs sampling biopsy, only need push the one of multistage dilating tube 101 to be the one-stage of diameter is the one-stage, slightly more than the second stage, so on the like push into human body cavity along puncture sampling needle tube 116, puncture sampling needle tube position, take out image lighting device (such as optic fibre mirror) from puncture sampling needle tube 116, take out the position is taken out through puncture sampling needle tube 116, if puncture sampling needle tube 116 is required to find the position through puncture sampling needle tube.
Laser treatment: after the pathological tissue in the human body cavity is probed and diagnosed, when the pathological tissue is required to be smashed and treated, the primary expansion tube enters the human body cavity, the position of the primary expansion tube entering the human body cavity is observed through an image lighting device (such as a fiber optic mirror) in the puncture sampling needle tube 116, and after the position is determined, the relative position of the puncture sampling needle tube 116 and the pathological tissue is observed and adjusted through the image lighting device (such as the fiber optic mirror). By inserting a laser therapeutic instrument (such as holmium laser fiber) from an instrument connector 207 on the endoscope handle 200, the laser therapeutic instrument enters the human body cavity through the puncture sampling needle tube 116, heat generated by holmium laser operation is taken away by water injected into the human body cavity and flows into a cavity gap between the laser therapeutic instrument and the puncture sampling needle tube 116 through a water outlet hole around the conical end of the expansion branch tube 102, and flows out of the negative pressure suction adjusting connector 113. In order to prevent the excessive pressure in the cavity in the operation process, the connectable negative pressure aspirator controls the size of the negative pressure suction adjusting port 114 by rotating the negative pressure suction adjusting sleeve 113.2, and meanwhile, the lesion tissues crushed by holmium laser can be sucked out of the body through the negative pressure suction adjusting joint 113, when the condition that the lesion tissues are difficult to crush and the large-size and high-power crushing and removing instruments are required to be established for a larger working channel is found in the operation process, the secondary expansion tube is pushed to the puncture port along the primary expansion tube, the conical tube at the front end of the secondary expansion tube is utilized to expand the puncture port, the secondary expansion tube enters the body cavity of a human body, the tube separating joint 103 of the primary expansion tube is detached and taken out from the body cavity along the tube cavity of the secondary expansion tube, the inner cavity of the secondary expansion tube is used as the working channel, and the crushing and removing instruments with the large size are selected to enter the secondary expansion tube cavity of the human body (such as the larger working channel is required in the operation, and the three-stage expansion tube and the subsequent multistage expansion tube are pushed according to the method).
The above description is only of the preferred embodiment of the present invention, and is not intended to limit the structure of the present invention in any way. Any simple modification, equivalent variation and modification of the above embodiments according to the technical substance of the present invention still fall within the scope of the technical solution of the present invention.
Claims (13)
1. An expanding sheath, includes expanding sheath handle (100) and the expansion pipe of being connected with expanding sheath handle (100) front end, its characterized in that: the expansion pipe is a multi-stage expansion pipe (101), the multi-stage expansion pipe (101) comprises a plurality of expansion branch pipes (102) with the outer diameters being coaxially sleeved in a descending order, each expansion branch pipe (102) is in axial sliding fit with the adjacent expansion branch pipe (102), and the length of the expansion branch pipe (102) with the large outer diameter is smaller than that of the expansion branch pipe with the small outer diameter; the outer surface of the front end of each expansion branch pipe (102) is conical, and a water outlet hole (105) is formed in the conical surface.
2. An endoscope having the dilating sheath of claim 1, comprising an endoscope handle (200), characterized in that: the dilating sheath handle (100) and the dilating tube are internally inserted with a puncture sampling needle tube (116); the rear end of the puncture sampling needle tube (116) is fixedly connected with a puncture sampling needle tube joint (117), and a shaft hole which is coaxially communicated with the puncture sampling needle tube (116) is formed in the puncture sampling needle tube joint (117) along the axial direction of the puncture sampling needle tube joint; the outer surface of the puncture sampling needle tube joint (117) is matched with the dilating sheath handle (100), and the rear end of the puncture sampling needle tube joint (117) is fixedly connected with the endoscope handle (200); the endoscope handle (200) is provided with an image lighting device channel (201) coaxially communicated with the puncture sampling needle tube joint (117) along the axial direction, and an image lighting device joint (202) is arranged at the port of the image lighting device channel (201).
3. The dilating sheath of claim 1, wherein: the rear end of each expansion branch pipe (102) is fixedly connected with a branch pipe joint (103), and the branch pipe joints (103) are sequentially and axially overlapped and movably connected into an integral multi-stage expansion pipe joint (104); the multi-stage expansion joint (104) is connected with the expansion sheath handle (100).
4. The dilating sheath of claim 3, wherein: one end of each branch pipe joint (103) is axially provided with a branch pipe joint positioning ring (103.1), and the other end of each branch pipe joint (103) is axially provided with an expansion branch pipe fixing hole (103.2) and a branch pipe joint positioning groove (103.3) corresponding to the branch pipe joint positioning ring (103.1) along the central axis; the rear end of each expansion branch pipe (102) is inserted into an expansion branch pipe fixing hole (103.2) of the corresponding branch pipe joint (103); the branch pipe joint positioning ring (103.1) of each branch pipe joint (103) is inserted into the branch pipe joint positioning groove (103.3) of the adjacent branch pipe joint (103);
The front end of the expansion sheath handle (100) is axially provided with a branch pipe joint positioning hole (106), and a branch pipe joint positioning ring (103.1) of the last section of branch pipe joint (103) of the multi-stage expansion pipe joint (104) is inserted into the branch pipe joint positioning hole (106) so that the multi-stage expansion pipe joint (104) is connected with the expansion sheath handle (100).
5. The dilating sheath of claim 4, wherein: a puncture sampling channel (107) which is penetrated from front to back is arranged in the expanding sheath handle (100) along the axial direction; the rear end of the dilating sheath handle (100) is coaxially connected with a puncture sampling needle tube positioning joint (108).
6. The dilating sheath of claim 5, wherein: the rear end of the dilating sheath handle (100) connected with the puncture sampling needle tube positioning joint (108) is provided with external threads, the puncture sampling needle tube positioning joint (108) is composed of a threaded sleeve (109) and a rubber ring (110), and a dilating sheath handle positioning hole (119), a rubber ring positioning hole (120) and a puncture sampling needle tube joint positioning hole (121) are sequentially formed in the threaded sleeve (109) from front to back along the axial direction; an internal thread is arranged on the hole wall of the expanding sheath handle positioning hole (119) and is matched with an external thread at the rear end of the expanding sheath handle (100); the utility model discloses a puncture sampling needle tube, including rubber circle locating hole (120), screw sleeve (109) are equipped with in rubber circle locating hole (120) can with puncture sampling needle tube (116) surface complex rubber circle (110), be equipped with in screw sleeve (109) the restriction limit mesa (111) of rubber circle (110) compressed position, the front end of rubber circle (110) with the rear end contact of expanding sheath handle (100), the rear end of rubber circle (110) with limit mesa (111) contact.
7. The dilating sheath of claim 6, wherein: the puncture sampling needle tube joint positioning hole (121) is a conical hole with a small hole diameter close to one end of the rubber ring positioning hole (120) and a large hole diameter far away from one end of the rubber ring positioning hole (120), the hole diameter of the rubber ring positioning hole (120) is larger than the hole diameter of the puncture sampling needle tube joint positioning hole (121) close to one end of the rubber ring positioning hole (120), and the transition surface of the rubber ring positioning hole (120) and the puncture sampling needle tube joint positioning hole (121) is the limiting table top (111).
8. The dilating sheath of claim 5, wherein: the side part of the dilating sheath handle (100) is connected with a negative pressure connecting pipe (112) communicated with the puncture sampling channel (107), and the end part of the negative pressure connecting pipe (112) is fixedly connected with a negative pressure suction adjusting joint (113).
9. The dilating sheath of claim 8, wherein: the negative pressure suction adjusting joint (113) comprises a negative pressure suction sleeve (113.1) which is coaxially and fixedly communicated with the negative pressure connecting pipe (112), a negative pressure suction adjusting opening (114) which is communicated with the negative pressure connecting pipe (112) is formed in the surface of the negative pressure suction sleeve (113.1), the negative pressure suction adjusting sleeve (113.2) is coaxially sleeved on the negative pressure suction sleeve (113.1), a negative pressure suction adjusting through opening (115) which corresponds to the negative pressure suction adjusting opening (114) is formed in the negative pressure suction adjusting sleeve (113.2), and a negative pressure pipe joint (113.3) is coaxially and fixedly communicated with the negative pressure suction sleeve (113.1).
10. The dilating sheath of claim 9, wherein: the negative pressure suction sleeve (113.1) is characterized in that a ring groove is formed in the circumferential surface of the negative pressure suction sleeve (113.1), a negative pressure suction sleeve sealing ring (118) is fixed in the ring groove, and the negative pressure suction sleeve sealing ring (118) is in contact with the inner surface of the negative pressure suction adjusting sleeve (113.2).
11. An endoscope as defined in claim 2, wherein: the puncture sampling needle tube joint (117) comprises a needle tube joint handheld seat (117.1), one side of the needle tube joint handheld seat (117.1) is coaxially and fixedly connected with a needle tube joint positioning seat (117.2) matched with a puncture sampling needle tube joint positioning hole (121), one end of a puncture sampling needle tube (116) which is far away from a multistage expansion tube (101) is coaxially fixed in the needle tube joint positioning seat (117.2), the other side of the needle tube joint handheld seat (117.1) is coaxially fixed with a needle tube joint fixing cylinder (117.3), the surface of the needle tube joint fixing cylinder (117.3) is provided with threads, one end of an endoscope handle (200) is axially provided with an endoscope handle threaded hole (203), the needle tube joint fixing cylinder (117.3) is in threaded connection with the endoscope handle threaded hole (203), and the image lighting device channel (201) is coaxially communicated with the endoscope handle threaded hole (203).
12. An endoscope as defined in claim 11, wherein: an ultrasonic developing groove (122) is formed in the surface, close to one end of the multistage expansion tube (101), of the puncture sampling needle tube (116), and a sampling inverted hook opening (124) is formed in the surface.
13. An endoscope as defined in claim 2, wherein: a water injection channel (204) and an instrument channel (205) which are communicated with the image lighting device channel (201) are further formed in the endoscope handle (200), and a water injection joint (206) which is coaxially communicated with the water injection channel (204) and an instrument joint (207) which is coaxially communicated with the instrument channel (205) are fixedly connected to the endoscope handle (200).
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| CN201810968916.4A CN108992144B (en) | 2018-08-23 | 2018-08-23 | Dilating sheath and endoscope with dilating sheath |
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| CN201810968916.4A CN108992144B (en) | 2018-08-23 | 2018-08-23 | Dilating sheath and endoscope with dilating sheath |
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| CN108992144B true CN108992144B (en) | 2024-06-04 |
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Families Citing this family (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109938811B (en) * | 2019-04-02 | 2024-04-16 | 海盐康源医疗器械有限公司 | Minimally invasive visual expansion suction sheath |
| CN110720969B (en) * | 2019-10-17 | 2021-01-15 | 深圳泰睿仕医疗科技有限公司 | Disposable minimally invasive dilation drainage kit |
| CN111449730B (en) * | 2020-04-03 | 2021-03-19 | 吉林大学 | Safe puncture channel expanding device for intravascular interventional therapy |
| CN114073568A (en) * | 2020-08-12 | 2022-02-22 | 上海康路联医疗科技有限公司 | Dilating sheath assembly |
| CN112656458B (en) * | 2020-11-27 | 2022-08-30 | 中国人民解放军空军军医大学 | Fusion system device under spinal endoscopy |
| CN115089091B (en) * | 2022-06-30 | 2023-06-30 | 湖南省华芯医疗器械有限公司 | Suction valve assembly, endoscope handle and endoscope |
| CN116763409B (en) * | 2023-08-25 | 2023-11-03 | 中国人民解放军总医院第三医学中心 | Ultrasonic guiding therapeutic device |
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| CN108992144A (en) | 2018-12-14 |
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