CN110840504A

CN110840504A - Ureter plugging device with sacculus

Info

Publication number: CN110840504A
Application number: CN201911029368.XA
Authority: CN
Inventors: 张福霖; 祝钦; 徐锦斌; 孙赐铭; 王贝
Original assignee: Individual
Current assignee: Individual
Priority date: 2019-10-28
Filing date: 2019-10-28
Publication date: 2020-02-28

Abstract

The invention relates to the technical field of medical equipment, in particular to a ureter plugging device with a balloon, which comprises a catheter and the balloon, wherein the catheter is hollow, the balloon is wrapped on the outer wall of the catheter, and at least one through hole is formed in the side wall of the catheter in the balloon; the catheter also comprises a guide wire and a plugging device, wherein one end of the guide wire penetrates through the side wall of the catheter to be connected with the plugging device, and the other end of the guide wire is pulled to drive the plugging device to be attached to the end part of the catheter to plug the opening. The invention plays a role in drainage before operation, and can establish artificial hydronephrosis by injecting normal saline through a catheter; the expansion of the saccule plays a role in blocking in the operation, and can prevent the broken stone from going down to the ureter in the percutaneous nephrolithotomy, thereby avoiding the stone from remaining in the ureter, reducing the operation difficulty and the operation time, increasing the stone clearance rate and reducing the occurrence rate of the stone street of the ureter after the operation. In addition, the invention can be used for assisting the retention of double J tubes after percutaneous nephrolithotomy, shortening the operation time, reducing the occurrence of operation complications and lowering the treatment cost.

Description

Ureter plugging device with sacculus

Technical Field

The invention relates to the technical field of medical equipment, in particular to a ureter plugging device with a balloon.

Background

The treatment of kidney stones mainly comprises operations and drug calculus removal treatment, wherein when the kidney stones are larger than 20mm or complex stones, percutaneous nephrolithotripsy is required for treatment. At present, percutaneous nephrolithotomy has the advantages of high lithotripsy efficiency, small surgical wound and quick postoperative recovery, and becomes a main treatment means for treating kidney stones. During percutaneous nephrolithotomy, an operator usually places a ureteral catheter in the affected ureter before lithotripsy. However, conventional ureteral catheters are only 4Fr to 5Fr in diameter, and have a very limited ability to block the passage of intraoperative debris down the ureter. In the process of percutaneous nephrolithotomy, a part of crushed stone with the size of 3 mm-4 mm often moves towards the ureter along with the direction of perfusate. When the crushed stone goes downwards to exceed the middle section or the lower section of the ureter from the upper section of the ureter, the crushed stone is difficult to take out through a percutaneous nephroscope, and the patient usually needs to be put into a lithotomy position again to carry out ureteroscopy stone taking operation to treat the downwards crushed stone, so the operation difficulty is increased, the operation time is prolonged, and the risk of occurrence of related complications such as a stone street after the operation is increased; in addition, the calculus descending to the ureter is difficult to detect under a nephroscope, and is easy to cause omission of an operator, so that the calculus is remained in the ureter after the operation, the calculus removing rate and the operation effect are reduced, and the risk of secondary operation is increased.

At present, a mechanical occluder is proposed abroad, enters a ureter through a ureteroscope, is placed into the upper section of the ureter, and is operated to form an umbrella-shaped structure after a percutaneous kidney channel is established, so that stone fragments are prevented from falling into the upper section of the ureter, but the umbrella-shaped structure formed by the occluder is always provided with pores and can not completely occlude broken stones; and the manufacturing cost is high and the price is expensive. In addition, chinese patent CN201510386032.4 discloses an occluder for ureteroscope lithotripsy, in which a blocking balloon is wrapped on the outer surface of a catheter to form a closed balloon with the catheter, and the occluding balloon is expanded outwards to fit the inner wall of the ureter by inflating the balloon or injecting physiological saline into the balloon to occlude ureter calculus tightly and prevent ureter lithotripsy, but: on one hand, the one-way valve is inconvenient for injecting contrast medium in a retrograde direction and injecting water to the renal calyx in the renal pelvis in the retrograde direction to establish artificial hydronephrosis; on the one hand, the structure is complex and the manufacturing cost is high.

Disclosure of Invention

The invention aims to overcome the defects of the prior art, and provides a ureter plugging device with a balloon, which can effectively avoid calculus from being left in a ureter, reduce the operation difficulty and the operation time, and increase the calculus removal rate. Reduce the incidence of ureter stone street after operation.

In order to solve the technical problems, the invention adopts the technical scheme that:

the ureteral occlusion device with the balloon comprises a catheter and the balloon, wherein the catheter is hollow, the balloon is wrapped on the outer wall of the catheter, and at least one through hole is formed in the side wall of the catheter in the balloon; still include seal wire and plugging device, the one end of seal wire is passed the pipe lateral wall and is connected with the plugging device, and the other end that pulls the seal wire can drive the plugging device laminating pipe end shutoff opening.

Before percutaneous nephroscope lithotripsy is carried out, a catheter is placed in a retrograde ureteroscope, the balloon is in an unexpanded state, the occluder is pushed out of an opening of the catheter through a guide wire, physiological saline is injected into the catheter by using an injector/connecting pipe, the physiological saline flows into the upper ureter section and the renal pelvis through the catheter, and artificial hydronephrosis is established. The operator uses the artificial hydronephrosis made by the ureteral catheter to establish a percutaneous renal channel. After the percutaneous renal passage is established, under the direct vision of a nephroscope, the guide wire tightens the occluder, the occluder occludes the opening at the head of the catheter, and the physiological saline cannot flow out through the catheter. The normal saline is injected into the catheter by the injector, and the pressure in the balloon is increased to expand the balloon. After the saccule is expanded to a proper size, the catheter is pulled to seal the saccule at the junction of the upper ureter section and the renal pelvis so as to prevent calculus from remaining in the ureter in the operation. After the operation is finished, the physiological saline in the saccule is pumped out through the injector to ensure that the saccule is withered, and the saccule is slowly withdrawn from the ureteroscope along with the catheter, thus finishing the operation. The invention can effectively prevent the broken stone from descending to the ureter in the percutaneous nephrolithotomy, thereby avoiding the stone from remaining in the ureter, reducing the operation difficulty and the operation time, increasing the stone clearance rate and reducing the occurrence rate of the stone street of the ureter after the operation.

Further, the pipe is equipped with seal wire chamber and drainage chamber, the seal wire intracavity is worn to locate by the seal wire, through-hole intercommunication drainage chamber and sacculus. Pushing the guide wire to remove the blockage of the blockage device, injecting normal saline into a drainage cavity in the catheter by using the injector/connecting pipe, and enabling the normal saline to flow into the upper ureter section and the renal pelvis through the catheter to establish artificial hydronephrosis; and pulling the guide wire to enable the occluder to occlude the drainage cavity, injecting normal saline into the drainage cavity in the catheter by using the injector/connecting pipe, and enabling the normal saline to enter the balloon at the head of the catheter and expand the balloon.

Furthermore, the guide wire cavity is arranged on the side wall of the catheter, and the diameter of the drainage cavity is larger than that of the guide wire cavity. The guide wire cavity is arranged on the side wall of the catheter, the periphery of the catheter is of a smooth tubular structure, the whole catheter is small, the manufacturing process is simple, the ureter can easily pass through the catheter, and surrounding tissues are not easily damaged.

Furthermore, on the same cross section, the circle center of the cross section of the drainage cavity, the circle center of the cross section of the guide wire cavity and the circle center of the cross section of the outer contour of the catheter are collinear.

Furthermore, the occluder is a spherical structure with the diameter not smaller than the diameter of the drainage cavity, and the sphere center of the spherical structure is positioned on the central axis of the drainage cavity. The shape and the size of the occluder are favorable for enabling the occluder to occlude the drainage cavity when the guide wire is pulled.

Further, the one end that the plugging device was kept away from to the pipe is equipped with drainage portion and the seal wire portion that the separation set up, the drainage chamber is located the tip setting that drainage portion and seal wire were surpassed seal wire portion to the one end. The separation of the drainage part and the guide wire part is beneficial to the operation of connecting the guide wire and the drainage part, the injector or the connecting pipe by an operator.

Further, the balloon is arranged at one end of the catheter close to the occluder. Positioning the balloon to achieve: the operation of injecting contrast medium in a retrograde way, injecting water into the renal pelvis and calyx in a retrograde way to cause artificial hydronephrosis and sealing the drainage cavity by the expansion balloon can be realized by penetrating the catheter into the ureter once.

Furthermore, the balloon is obtained by bonding the edge of an elastic membrane to the outer wall of the catheter, and the surface of the elastic membrane is provided with a hydrophilic lubricating coating. The balloon has good elasticity, has good toughness after filling, is not easily scratched by stone fragments, and can effectively avoid the occurrence of plugging failure; and the outer surface of the elastic membrane has better biocompatibility, and can avoid the damage to the tissues of a patient in the operation.

Further, the guide wire is of a stainless steel wire-shaped structure or a titanium alloy wire-shaped structure. The medical stainless steel or titanium alloy is adopted for manufacturing, has better biocompatibility, and avoids secondary damage to patients caused by operations.

Further, the stopper is of a stainless steel structure, a plastic structure or a rubber structure. The stopper is made of common materials, so that the stopper is simple in manufacturing process, low in manufacturing cost and low in price, and is beneficial to wide popularization.

Compared with the prior art, the invention has the beneficial effects that:

the ureter plugging device with the saccule can prevent the crushed stone from descending to the ureter in the percutaneous nephrolithotomy, thereby avoiding the stone from remaining in the ureter, reducing the operation difficulty and the operation time, increasing the stone clearance rate and reducing the occurrence rate of the stone street of the ureter after the operation;

the ureter plugging device with the sacculus plays a role in drainage before operation, and can be used for establishing artificial hydronephrosis by injecting physiological saline through a catheter or injecting a contrast agent so as to facilitate development in the operation; the balloon expansion plays a role in blocking in the operation, and prevents the broken stone from going down to the ureter; whether the plugging device is plugged or not can be controlled by operating the guide wire, and the plugging device is simple in structure, convenient and fast to operate and high in feasibility;

the ureter blocking device with the sacculus can be used for assisting in remaining double J tubes after percutaneous nephrolithotomy, shortening the operation time, reducing the occurrence of operation complications and lowering the treatment cost.

Drawings

FIG. 1 is a schematic structural view of an occlusion device prior to balloon expansion;

FIG. 2 is a perspective view of the occlusion device prior to balloon expansion;

FIG. 3 is an enlarged partial view of the head end of the catheter prior to balloon dilation;

FIG. 4 is a schematic structural view of the occlusion device after balloon expansion;

FIG. 5 is a perspective view of the occlusion device after balloon expansion;

in the drawings: 1-a catheter; 11-a guidewire lumen; 12-a drainage lumen; 13-a drainage part; 14-a wire guide portion; 2-a balloon; 3-a through hole; 4-guide wire; 5-the stopper.

Detailed Description

The present invention will be further described with reference to the following embodiments. Wherein the showings are for the purpose of illustration only and are shown by way of illustration only and not in actual form, and are not to be construed as limiting the present patent; to better illustrate the embodiments of the present invention, some parts of the drawings may be omitted, enlarged or reduced, and do not represent the size of an actual product; it will be understood by those skilled in the art that certain well-known structures in the drawings and descriptions thereof may be omitted.

The same or similar reference numerals in the drawings of the embodiments of the present invention correspond to the same or similar components; in the description of the present invention, it should be understood that if there is an orientation or positional relationship indicated by the terms "upper", "lower", "left", "right", etc. based on the orientation or positional relationship shown in the drawings, it is only for convenience of describing the present invention and simplifying the description, but it is not intended to indicate or imply that the referred device or element must have a specific orientation, be constructed in a specific orientation, and be operated, and therefore, the terms describing the positional relationship in the drawings are only used for illustrative purposes and are not to be construed as limiting the present patent, and the specific meaning of the terms may be understood by those skilled in the art according to specific circumstances.

Examples

Fig. 1 to 5 show an embodiment of the ureteral occlusion device with a balloon, which includes a catheter 1 and a balloon 2, wherein the catheter 1 is hollow, the balloon 2 is wrapped on the outer wall of the catheter 1, and at least one through hole 3 is formed in the side wall of the catheter 1 inside the balloon 2; the catheter also comprises a guide wire 4 and an occluder 5, wherein one end of the guide wire 4 penetrates through the side wall of the catheter 1 to be connected with the occluder 5, and the other end of the guide wire 4 is pulled to drive the occluder 5 to be attached to the end part of the catheter 1 to occlude the opening.

In the present embodiment, before percutaneous nephrolithotomy, a retrograde ureteroscope is inserted into the catheter 1, and the balloon 2 is in an unexpanded state, as shown in fig. 1 to 3; pushing the occluder 5 out of the opening of the catheter 1 through the guide wire 4, injecting the physiological saline into the catheter 1 by using an injector/connecting pipe, and enabling the physiological saline to flow into the upper ureter section and the renal pelvis through the catheter 1 to establish artificial hydronephrosis; the operator establishes a percutaneous renal passage by using the artificial hydronephrosis manufactured by the ureteral catheter 1. After the percutaneous renal passage is established, under the direct vision of a nephroscope, the guide wire 4 tightens the occluder 5, the occluder 5 occludes the opening at the head of the catheter 1, and the physiological saline cannot flow out through the catheter 1. The injection of saline into the catheter 1 is continued by means of the syringe, whereupon the pressure in the balloon 2 increases and the balloon 2 expands, as shown in fig. 4 to 5. After the sacculus 2 is expanded to a proper size, the catheter 1 is pulled, so that the sacculus 2 is plugged at the junction of the upper ureter section and the renal pelvis, and calculus residues in the operation are prevented from reaching the ureter. After the operation is finished, the physiological saline in the balloon 2 is extracted by the syringe, the balloon 2 is shrunk, and the balloon 2 is slowly withdrawn from the ureteroscope along with the catheter 1, thereby finishing the operation. The invention can effectively prevent the broken stone from descending to the ureter in the percutaneous nephrolithotomy, thereby avoiding the stone from remaining in the ureter, reducing the difficulty of the operation and the operation time, increasing the stone clearance rate and reducing the occurrence rate of the stone street of the ureter after the operation.

As shown in fig. 1, the catheter 1 of the embodiment is provided with a guide wire cavity 11 and a drainage cavity 12, a guide wire 4 is arranged in the guide wire cavity 11 in a penetrating way, and a through hole 3 is communicated with the drainage cavity 12 and a balloon 2. The guide wire cavity 11 is used for passing through the guide wire 4, controlling the conduction of the drainage cavity 12 by operating the occluder 5 through the guide wire 4 and switching the occlusion function and the drainage function of the occlusion device; the drainage cavity 12 is used for injecting physiological saline, the catheter 1 is set to be the double-cavity catheter 1, the whole catheter 1 is in a slender shape, the manufacturing process is simple, the ureter can be easily passed, and surrounding tissues are not easily damaged.

In order to reasonably utilize the limited space of the catheter 1 and facilitate the injection operation of the physiological saline, the guide wire cavity 11 is arranged on the side wall of the catheter 1, and the diameter of the drainage cavity 12 is larger than that of the guide wire cavity 11; however, it should be noted that this is preferable for obtaining a catheter 1 having a smooth outer surface, a small overall size, and a simple manufacturing process so as to pass through the ureter without damaging the surrounding tissues during the operation, and is not intended to be a limiting provision.

In order to ensure the performance of the double-cavity of the catheter 1 on the premise that the material consumption of the catheter 1 is as low as possible, the circle center of the section of the drainage cavity 12, the circle center of the section of the guide wire cavity 11 and the circle center of the section of the outer contour of the catheter 1 are collinear on the same cross section. The circle centers of the outer contour section circle of the catheter 1 and the section circle of the drainage cavity 12 are not coincident, so that the side wall of the catheter 1 is in a water-drop shape, and the drainage cavity 12 is arranged at the thickest part of the side wall of the catheter 1. So set up: on one hand, the requirements of the aperture of the drainage cavity 12 and the aperture of the guide wire cavity 11 can be met at the same time, and the manufacturing process is simple, the material consumption is less, and the cost is low; on one hand, the whole catheter 1 is small, and the pressure of the drainage cavity 12 can be increased by using an injector in a small-pipe-diameter state, so that the effect of rapid water injection or drainage is achieved.

In order to better realize the plugging effect of the drainage cavity 12, the plugging device 5 of the present embodiment is configured as a spherical structure with a diameter not smaller than that of the drainage cavity 12, and the spherical center of the spherical structure is located on the central axis of the drainage cavity 12. So set up, when pulling seal wire 4, the centre of sphere of occluder 5 is close to along the central axis of drainage chamber 12 to drainage chamber 12, and occluder 5 can laminate drainage chamber 12 well, plays the shutoff effect.

In order to facilitate the operation of the occlusion device by the operator in the operation, in the embodiment, the drainage part 13 and the guide wire part 14 are separated from each other at one end of the catheter 1 away from the occlusion device 5, one end of the guide wire 4 extends out of the guide wire part 14, the other end of the guide wire passes through the guide wire cavity 11 from the guide wire part 14 until passing out of the guide wire cavity 11 to be connected with the occlusion device 5, and the drainage part 13 is used for connecting a connecting pipe or a. Therefore, an operator can separate the operation of the guide wire 4 from the injection operation in the operation, a larger operation space is reserved, and the operation of the blocking device is convenient.

In order to impart multiple functions to the occlusion device, the present embodiment provides a balloon 2 at one end of the catheter 1 near the occluding device 5. Thus, before percutaneous nephrolithotomy, a contrast agent can be injected by using an injector/connecting pipe so as to be developed in the operation and accurately perform percutaneous nephropuncture, physiological saline is injected into the catheter 1 by using the injector/connecting pipe, and the physiological saline flows into the upper ureter section and the renal pelvis through the catheter 1 to establish artificial hydronephrosis; the drainage cavity 12 can be plugged, physiological saline is continuously injected into the catheter 1, the pressure in the balloon 2 is increased and is continuously expanded, and the catheter 1 is pulled to plug the balloon 2 at the junction of the upper ureter section and the renal pelvis to realize plugging; after the operation is finished, the physiological saline in the sacculus 2 is pumped out through the injector, so that the sacculus 2 is atrophic, and the sacculus 2 is slowly withdrawn from the ureteroscope along with the catheter 1, thereby finishing the operation; the whole operation process only needs to insert the catheter 1 into the ureter once, the operation is simple and convenient, and the operation difficulty and the operation time can be reduced.

In order to reduce the manufacturing cost of the occlusion device, increase the compatibility of the occlusion device with human tissues, and avoid the injury to the patient during the operation of the occlusion device, in this embodiment: the balloon 2 is obtained by bonding the edge of an elastic membrane to the outer wall of the catheter 1, and the surface of the elastic membrane is provided with a hydrophilic lubricating coating; the guide wire 4 is a stainless steel wire-shaped structure or a titanium alloy wire-shaped structure; the stopper 5 is of a stainless steel structure, a plastic structure or a rubber structure.

The ureter blocking device with the sacculus of the embodiment not only has a drainage function and a blocking function, but also can be used for assisting the retention of the double J-shaped tube. After the percutaneous nephrolithotomy finishes the stone breaking and taking work, the double J tubes need to be kept. At this time, the occluder 5 and the guide wire 4 in the catheter 1 can be pulled out to the percutaneous renal passage by using a foreign body forceps, and the tail end of the double J-shaped tube is sleeved on the occluder 5. The catheter 1 is then withdrawn from the ureter by pulling on the guidewire 4 and the double J-tube is pulled to the ureter site. And finally, the double J tube is separated from the spherical stopper 5 by increasing the force of pulling the guide wire 4, and the double J tube is smoothly retained at the position of the ureter.

It should be understood that the above-described embodiments of the present invention are merely examples for clearly illustrating the present invention, and are not intended to limit the embodiments of the present invention. Other variations and modifications will be apparent to persons skilled in the art in light of the above description. And are neither required nor exhaustive of all embodiments. Any modification, equivalent replacement, and improvement made within the spirit and principle of the present invention should be included in the protection scope of the claims of the present invention.

Claims

1. The ureteral occlusion device with the balloon comprises a catheter (1) and the balloon (2), wherein the catheter (1) is hollow, the balloon (2) wraps the outer wall of the catheter (1), and at least one through hole (3) is formed in the side wall of the catheter (1) in the balloon (2); the device is characterized by further comprising a guide wire (4) and an occluder (5), wherein one end of the guide wire (4) penetrates through the side wall of the catheter (1) to be connected with the occluder (5), and the other end of the guide wire (4) is pulled to drive the occluder (5) to be attached to the end of the catheter (1) to occlude the opening.

2. The ureteral occlusion device with balloon according to claim 1, characterized in that the catheter (1) is provided with a guide wire cavity (11) and a drainage cavity (12), the guide wire (4) is arranged in the guide wire cavity (11), and the through hole (3) is communicated with the drainage cavity (12) and the balloon (2).

3. The balloon ureteral occlusion device according to claim 2, characterized in that the guidewire lumen (11) opens out in the side wall of the catheter (1), and the diameter of the drainage lumen (12) is larger than the diameter of the guidewire lumen (11).

4. The vesicular ureteral occlusion device of claim 3, wherein the centers of the cross-section of the drainage lumen (12), the guide wire lumen (11) and the catheter (1) are collinear on the same cross-section.

5. The vesicular ureteral occlusion device of claim 2, wherein the occluder (5) is a spherical structure having a diameter no less than the diameter of the drainage lumen (12), the spherical center of the spherical structure being located on the central axis of the drainage lumen (12).

6. The balloon ureteral occlusion device according to claim 2, wherein the end of the catheter (1) away from the occluder (5) is provided with a drainage portion (13) and a guide wire portion (14) which are separately arranged, the drainage lumen (12) is provided in the drainage portion (13), and one end of the guide wire (4) is arranged to extend out of the end of the guide wire portion (14).

7. The vesicular ureteral occlusion device of any of claims 1 to 6, wherein the balloon (2) is provided at an end of the catheter (1) near the occluder (5).

8. The ureteral occlusion device with balloon according to claim 7, characterized in that the balloon (2) is obtained by bonding the edge of an elastic membrane to the outer wall of the catheter (1), the surface of said elastic membrane being provided with a hydrophilic lubricating coating.

9. The balloon ureteral occlusion device according to claim 1, wherein the guidewire (4) is a stainless steel wire-like structure or a titanium alloy wire-like structure.

10. The balloon ureteral occlusion device according to claim 1, wherein the occluder (5) is of stainless steel construction, plastic construction or rubber construction.