CN109124700B - Common bile duct exploration sheath tube - Google Patents
Common bile duct exploration sheath tube Download PDFInfo
- Publication number
- CN109124700B CN109124700B CN201810838617.9A CN201810838617A CN109124700B CN 109124700 B CN109124700 B CN 109124700B CN 201810838617 A CN201810838617 A CN 201810838617A CN 109124700 B CN109124700 B CN 109124700B
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- pipe
- vertical
- tube
- bile duct
- horizontal
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- 210000001953 common bile duct Anatomy 0.000 title claims abstract description 36
- 230000000151 anti-reflux effect Effects 0.000 claims abstract description 9
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 claims abstract description 9
- VYPSYNLAJGMNEJ-UHFFFAOYSA-N Silicium dioxide Chemical compound O=[Si]=O VYPSYNLAJGMNEJ-UHFFFAOYSA-N 0.000 claims description 5
- 239000000741 silica gel Substances 0.000 claims description 5
- 229910002027 silica gel Inorganic materials 0.000 claims description 5
- 208000005646 Pneumoperitoneum Diseases 0.000 abstract description 10
- 210000000941 bile Anatomy 0.000 abstract description 8
- 239000004575 stone Substances 0.000 abstract description 8
- 210000000683 abdominal cavity Anatomy 0.000 abstract description 7
- 208000015181 infectious disease Diseases 0.000 abstract description 4
- 239000012530 fluid Substances 0.000 abstract description 3
- 238000011010 flushing procedure Methods 0.000 abstract description 3
- 230000002458 infectious effect Effects 0.000 abstract description 3
- 230000007774 longterm Effects 0.000 abstract description 2
- 239000000126 substance Substances 0.000 abstract description 2
- CURLTUGMZLYLDI-UHFFFAOYSA-N Carbon dioxide Chemical compound O=C=O CURLTUGMZLYLDI-UHFFFAOYSA-N 0.000 description 4
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 4
- 210000003228 intrahepatic bile duct Anatomy 0.000 description 4
- 238000000034 method Methods 0.000 description 4
- 201000010099 disease Diseases 0.000 description 3
- 238000000605 extraction Methods 0.000 description 3
- 206010060921 Abdominal abscess Diseases 0.000 description 2
- 206010004637 Bile duct stone Diseases 0.000 description 2
- 210000003815 abdominal wall Anatomy 0.000 description 2
- 229910002092 carbon dioxide Inorganic materials 0.000 description 2
- 239000001569 carbon dioxide Substances 0.000 description 2
- 230000007547 defect Effects 0.000 description 2
- 238000011084 recovery Methods 0.000 description 2
- 206010000050 Abdominal adhesions Diseases 0.000 description 1
- 208000010444 Acidosis Diseases 0.000 description 1
- 206010001526 Air embolism Diseases 0.000 description 1
- 206010016717 Fistula Diseases 0.000 description 1
- 238000010521 absorption reaction Methods 0.000 description 1
- 230000007950 acidosis Effects 0.000 description 1
- 208000026545 acidosis disease Diseases 0.000 description 1
- 230000001154 acute effect Effects 0.000 description 1
- 238000013459 approach Methods 0.000 description 1
- 238000005452 bending Methods 0.000 description 1
- 210000000013 bile duct Anatomy 0.000 description 1
- 230000000903 blocking effect Effects 0.000 description 1
- 238000004140 cleaning Methods 0.000 description 1
- 238000011161 development Methods 0.000 description 1
- 208000035475 disorder Diseases 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 210000002603 extrahepatic bile duct Anatomy 0.000 description 1
- 230000003890 fistula Effects 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
- 208000003243 intestinal obstruction Diseases 0.000 description 1
- 238000002350 laparotomy Methods 0.000 description 1
- 239000007788 liquid Substances 0.000 description 1
- 229940057995 liquid paraffin Drugs 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000010992 reflux Methods 0.000 description 1
- 230000001105 regulatory effect Effects 0.000 description 1
- 230000029058 respiratory gaseous exchange Effects 0.000 description 1
- 239000000523 sample Substances 0.000 description 1
- 238000006467 substitution reaction Methods 0.000 description 1
- 210000003462 vein Anatomy 0.000 description 1
Classifications
-
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
-
- 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
- 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
- A61B2017/0034—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means adapted to be inserted through a working channel of an endoscope
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0801—Prevention of accidental cutting or pricking
- A61B2090/08021—Prevention of accidental cutting or pricking of the patient or his organs
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2217/00—General characteristics of surgical instruments
- A61B2217/002—Auxiliary appliance
- A61B2217/005—Auxiliary appliance with suction drainage system
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Molecular Biology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Pathology (AREA)
- Endoscopes (AREA)
Abstract
The invention discloses a common bile duct exploration sheath tube, which is characterized in that: comprises a horizontal tube and a vertical tube positioned at the head of the sheath tube; the horizontal pipe is communicated with the vertical pipe through an elbow pipe; an opening is formed in one end, far away from the bent pipe, of the horizontal pipe; the outer edge pipe wall of the bent pipe is provided with a through hole; the outer wall of the vertical pipe is provided with a water outlet joint; a base is arranged at one end of the vertical pipe far away from the bent pipe; a channel communicated with the vertical pipe is arranged in the base; the inner wall of the channel is provided with an anti-reflux pad; the anti-reflux pad is provided with an elastic hole for the choledochoscope to pass through. After the pneumoperitoneum and the laparoscope video can be closed after the pneumoperitoneum enters the common bile duct, so that complications generated by long-term pneumoperitoneum and loss of a laparoscope system are avoided; the water outlet joint is connected with the negative pressure suction tube, so that infectious bile, flushing fluid, sediment-like stones, bile mud and the like can be discharged out of the body, and complications caused by the substances entering the abdominal cavity can be reduced.
Description
Technical Field
The invention relates to a common bile duct exploration sheath, in particular to a common bile duct exploration sheath for a choledochoscope.
Background
Calculus of intrahepatic bile duct is a common disease and frequently-occurring disease in China, common bile duct exploration and calculus removal are main operation modes for treating the disease, and the traditional operation scheme is open-abdomen common bile duct exploration, and has the defects of large wound, slow recovery and the like. Along with the development of laparoscope and choledochoscope technologies, currently, a laparoscopic common bile duct exploration and choledochoscope stone extraction treatment scheme is adopted for treating intrahepatic and extrahepatic bile duct stones, and compared with the traditional laparotomy, the method has the advantages of small wound, quick recovery, fewer complications and the like.
At present, when a choledochoscope is placed in a sleeve of an abdominal cavity puncture outfit to perform common bile duct exploration and stone extraction, the mode has a plurality of defects: 1. pneumoperitoneum is required to be established in the whole operation process, and the long-time pneumoperitoneum is easy to influence the swing of diaphragm, influence the breathing and circulation, and can cause acidosis and ion disorder due to the absorption of a large amount of carbon dioxide, and high-pressure carbon dioxide flows back through veins and even causes gas embolism, so that the life of a patient is endangered; 2. in the process of probing by a choledochoscope, a large amount of infectious bile, broken stone, bile mud and choledochoscope flushing fluid flow into the abdominal cavity through the incision, so that abdominal cavity infection and abdominal abscess are easily caused, and after the broken stone and the bile mud enter the abdominal cavity, the cleaning is difficult, so that complications such as abdominal adhesion, intestinal obstruction, internal fistula, abdominal abscess and the like are caused; 3. after the common bile duct is cut, the pressure of the common bile duct is reduced and collapses, and the difficulty of entering the common bile duct by the choledochoscope is increased; 4. the outer sleeve of the poking card is made of hard plastic, and the end wall of the head end of the outer sleeve is easy to damage the choledochoscope.
Disclosure of Invention
According to the technical problem set forth above, a common bile duct exploration sheath is provided. The invention adopts the following technical means:
A common bile duct exploration sheath tube, which comprises a horizontal tube and a vertical tube which are positioned at the head part of the sheath tube;
the horizontal pipe is communicated with the vertical pipe through an elbow, namely the head end of the sheath pipe is L-shaped;
an opening is formed in one end, far away from the bent pipe, of the horizontal pipe;
The outer edge pipe wall of the bent pipe is provided with a through hole;
the outer wall of the vertical pipe is provided with a water outlet joint;
a base is arranged at one end of the vertical pipe far away from the bent pipe;
a channel communicated with the vertical pipe is arranged in the base;
the inner wall of the channel is provided with an anti-reflux pad;
The anti-reflux pad is made of silica gel;
the anti-reflux pad is provided with an elastic hole for the choledochoscope to pass through, and after the choledochoscope passes through the elastic hole, the elastic hole is attached to the choledochoscope to form a seal, so that reflux is prevented.
The shape of the through hole is consistent with the orthographic projection (projection is carried out along the axis direction of the horizontal pipe) of the opening on the bent pipe after the opening is inclined for 15 degrees to the bent pipe around the upper end of the through hole;
the included angle between the plane where the through hole is located and the vertical pipe axis is more than 45 degrees and less than or equal to 60 degrees.
After the horizontal pipe is placed into the common bile duct, the part, close to the vertical pipe, of the through hole cannot be exposed out of the common bile duct, and the projection of the through hole along the axial direction of the vertical pipe is smaller than the inner diameter of the vertical pipe.
The horizontal pipe, the bent pipe and the vertical pipe are made of silica gel, so that the horizontal pipe, the bent pipe and the vertical pipe are elastic, the bent pipe is bent to a certain degree, and the sheath pipe can be bent to be straight at the bent pipe basically due to the fact that the through holes are formed in the outer edge pipe wall of the bent pipe, and then the sheath pipe is clamped into the abdominal cavity through the poking.
The outer diameter of the vertical pipe is 0.9cm, and the inner diameter of the poking clamp is basically 1cm, so that the outer diameter of the vertical pipe is slightly smaller than 1 cm;
The outer diameter of the horizontal pipe is 6mm, 8mm or is consistent with the outer diameter of the vertical pipe.
The length of the tube section of the sheath tube head exceeding the cylindrical surface where the vertical tube is positioned is 1cm.
The wall thickness of the horizontal pipe, the bent pipe and the vertical pipe is 1mm, so that the horizontal pipe, the bent pipe and the vertical pipe are well supported.
The length of the vertical tube is 30-60 cm, and the vertical tube can directly reach the common bile duct through the abdominal wall.
Compared with the prior art, the invention has the following advantages:
1. the head end of the sheath tube is L-shaped, a through hole is arranged on the outer edge tube wall of the bent tube, and the bent tube can be placed into the poking outer sleeve after a proper amount of bending;
2. the head end of the sheath tube is L-shaped and is placed into the common bile duct through the common bile duct incision, so that the fixing effect is good;
3. the horizontal pipe, the bent pipe and the vertical pipe are made of silica gel, so that damage to the choledochoscope caused by blocking the outer sleeve wall in the choledochoscope stone taking process is avoided;
4. The head end of the sheath tube is L-shaped, a through hole is arranged on the outer edge tube wall of the bent tube, and the choledochoscope can probe the lower section and the upper section of the common bile duct through the opening on the horizontal tube and the through hole on the outer edge tube wall of the bent tube;
5. after the sheath tube enters the common bile duct, pneumoperitoneum and laparoscope videos can be closed, and complications generated by long-term pneumoperitoneum and loss of a laparoscope system are avoided;
6. the choledochoscope can directly enter the common bile duct along the sheath pipe, and the directions of the lower section and the upper section of the common bile duct are identified through the opening on the horizontal pipe and the through hole on the outer edge pipe wall of the bent pipe;
7. The water outlet joint is connected with the negative pressure suction tube, so that infectious bile, flushing fluid, sediment-like stones, bile mud and the like can be discharged out of the body, and complications caused by the substances entering the abdominal cavity can be reduced.
For the above reasons, the invention can be widely popularized in the fields of medical appliances and the like.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings that are required in the embodiments or the description of the prior art will be briefly described, and it is obvious that the drawings in the following description are some embodiments of the present invention, and other drawings may be obtained according to the drawings without inventive effort to a person skilled in the art.
FIG. 1 is a schematic view of a common bile duct exploring sheath in an operative state in an embodiment of the present invention.
Fig. 2 is a schematic view of a bile duct exploring sheath in an operative state (insertion of a choledochoscope) according to an embodiment of the present invention.
Detailed Description
For the purpose of making the objects, technical solutions and advantages of the embodiments of the present invention more apparent, the technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present invention, and it is apparent that the described embodiments are some embodiments of the present invention, but not all embodiments of the present invention. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.
As shown in fig. 1 and 2, a common bile duct exploration sheath comprises a horizontal tube 1 and a vertical tube 2 positioned at the head of the sheath;
the horizontal pipe 1 is communicated with the vertical pipe 2 through an elbow pipe 3;
the end of the horizontal pipe 1, which is far away from the bent pipe 3, is provided with an opening 4;
the outer edge pipe wall of the bent pipe 3 is provided with a through hole 5;
the outer wall of the vertical pipe 2 is provided with a water outlet joint 6;
a base 7 is arranged at one end of the vertical pipe 2 far away from the bent pipe 3;
A channel 8 communicated with the vertical pipe 2 is arranged in the base 7;
An anti-reflux pad 9 is arranged on the inner wall of the channel 8;
The anti-reflux pad 9 is provided with an elastic hole 11 for the choledochoscope 10 to pass through.
The shape of the through hole 5 is consistent with the orthographic projection of the opening 4 which is inclined by 15 degrees to the bent pipe 3 around the upper end of the opening and then is arranged on the bent pipe 3;
the included angle between the plane of the through hole 5 and the axis of the vertical pipe 2 is more than 45 degrees and less than or equal to 60 degrees.
The horizontal pipe 1, the bent pipe 3 and the vertical pipe 2 are made of silica gel.
The outer diameter of the vertical tube 2 is 0.9cm;
The outer diameter of the horizontal pipe 1 is 6mm, 8mm or is identical to the outer diameter of the vertical pipe 2.
The length of the tube section of the sheath tube head exceeding the cylindrical surface where the vertical tube 2 is positioned is 1cm.
The wall thickness of the horizontal pipe 1, the bent pipe 3 and the vertical pipe 2 is 1mm.
The length of the vertical pipe 2 is 30-60 cm.
Establishing pneumoperitoneum, placing a poking card through the abdominal wall, taking out a poking card pushing rod, and connecting a water outlet joint 6 with a negative pressure suction pipe to enable the horizontal pipe 1, the bent pipe 3 and the vertical pipe 2 to be communicated with the negative pressure suction pipe.
The sheath tube is placed in the outer sleeve of the poking clamp and gradually approaches to the notch of the common bile duct 12, the sheath tube enters the common bile duct 12 through the notch, when the vertical tube 2 and the common bile duct 12 form an obtuse angle, the sheath tube head upwards enters the far end of the notch of the common bile duct 12, and when the vertical tube 2 and the common bile duct 12 form an acute angle, the sheath tube head upwards enters the near end of the notch of the common bile duct 12.
The negative pressure suction pressure of the negative pressure suction tube is regulated to ensure that the negative pressure water yield is the same as the water yield and the bile yield of the choledochoscope 10, and the collapse of the common bile duct 12 or the overflow of liquid in the common bile duct 12 through an incision is avoided.
Closing pneumoperitoneum, stopping the laparoscopic video system, injecting liquid paraffin into the sheath tube, placing a choledochoscope 10 from an elastic hole 11, and enabling the choledochoscope 10 to enter an intrahepatic bile duct through an opening 4 on the horizontal tube 1 and a through hole 5 on the outer edge tube wall of the bent tube 3 to perform exploration and stone extraction.
After removal of intrahepatic bile duct stones, the pneumoperitoneum is again established and the laparoscopic system opened, the sheath is removed and the common bile duct 12 incision is sutured.
Finally, it should be noted that: the above embodiments are only for illustrating the technical solution of the present invention, and not for limiting the same; although the invention has been described in detail with reference to the foregoing embodiments, it will be understood by those of ordinary skill in the art that: the technical scheme described in the foregoing embodiments can be modified or some or all of the technical features thereof can be replaced by equivalents; such modifications and substitutions do not depart from the spirit of the invention.
Claims (1)
1. A common bile duct exploration sheath, characterized in that: comprises a horizontal tube and a vertical tube positioned at the head of the sheath tube;
The horizontal pipe is communicated with the vertical pipe through an elbow pipe;
an opening is formed in one end, far away from the bent pipe, of the horizontal pipe;
The outer edge pipe wall of the bent pipe is provided with a through hole;
the outer wall of the vertical pipe is provided with a water outlet joint;
a base is arranged at one end of the vertical pipe far away from the bent pipe;
a channel communicated with the vertical pipe is arranged in the base;
the inner wall of the channel is provided with an anti-reflux pad;
The anti-reflux pad is provided with an elastic hole for a choledochoscope to pass through;
The shape of the through hole is consistent with the orthographic projection of the opening on the bent pipe after the opening is inclined for 15 degrees around the upper end of the through hole to the bent pipe;
The included angle between the plane of the through hole and the vertical pipe axis is more than 45 degrees and less than or equal to 60 degrees;
the horizontal pipe, the bent pipe and the vertical pipe are made of silica gel;
the outer diameter of the vertical tube is 0.9cm;
the outer diameter of the horizontal pipe is 6mm, 8mm or is consistent with the outer diameter of the vertical pipe;
The length of the tube section of the sheath tube head exceeding the cylindrical surface where the vertical tube is positioned is 1cm;
the wall thickness of the horizontal pipe, the bent pipe and the vertical pipe is 1mm;
the length of the vertical pipe is 30-60 cm.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201810838617.9A CN109124700B (en) | 2018-07-27 | 2018-07-27 | Common bile duct exploration sheath tube |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201810838617.9A CN109124700B (en) | 2018-07-27 | 2018-07-27 | Common bile duct exploration sheath tube |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN109124700A CN109124700A (en) | 2019-01-04 |
| CN109124700B true CN109124700B (en) | 2024-05-14 |
Family
ID=64799180
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201810838617.9A Active CN109124700B (en) | 2018-07-27 | 2018-07-27 | Common bile duct exploration sheath tube |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN109124700B (en) |
Families Citing this family (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN111514437B (en) * | 2020-05-06 | 2022-09-16 | 徐州市肿瘤医院 | Integrated laparoscopic common bile duct T-tube implantation device and method |
| CN113712495B (en) * | 2021-09-16 | 2022-09-23 | 浙江大学 | Tubular device for guiding operation of choledochoscope during endoscopic common bile duct exploration |
Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6440061B1 (en) * | 2000-03-24 | 2002-08-27 | Donald E. Wenner | Laparoscopic instrument system for real-time biliary exploration and stone removal |
| CN209074712U (en) * | 2018-07-27 | 2019-07-09 | 上海市东方医院 | Exploration of common bile duct sheath |
-
2018
- 2018-07-27 CN CN201810838617.9A patent/CN109124700B/en active Active
Patent Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6440061B1 (en) * | 2000-03-24 | 2002-08-27 | Donald E. Wenner | Laparoscopic instrument system for real-time biliary exploration and stone removal |
| CN209074712U (en) * | 2018-07-27 | 2019-07-09 | 上海市东方医院 | Exploration of common bile duct sheath |
Also Published As
| Publication number | Publication date |
|---|---|
| CN109124700A (en) | 2019-01-04 |
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