CN110897601B - Ureter soft-lens diagnosis and treatment method and device integrated with guide sheath - Google Patents
Ureter soft-lens diagnosis and treatment method and device integrated with guide sheath Download PDFInfo
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- CN110897601B CN110897601B CN201911263657.6A CN201911263657A CN110897601B CN 110897601 B CN110897601 B CN 110897601B CN 201911263657 A CN201911263657 A CN 201911263657A CN 110897601 B CN110897601 B CN 110897601B
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- 210000000626 ureter Anatomy 0.000 title claims abstract description 57
- 238000000034 method Methods 0.000 title abstract description 24
- 238000003745 diagnosis Methods 0.000 title abstract description 10
- 230000010354 integration Effects 0.000 claims 1
- 210000003708 urethra Anatomy 0.000 description 16
- 210000003932 urinary bladder Anatomy 0.000 description 13
- 239000004575 stone Substances 0.000 description 12
- 238000003780 insertion Methods 0.000 description 9
- 230000037431 insertion Effects 0.000 description 9
- 230000002485 urinary effect Effects 0.000 description 9
- 210000003734 kidney Anatomy 0.000 description 6
- 239000000835 fiber Substances 0.000 description 3
- 238000012544 monitoring process Methods 0.000 description 3
- 230000006378 damage Effects 0.000 description 2
- 238000002674 endoscopic surgery Methods 0.000 description 2
- 238000000926 separation method Methods 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 208000000913 Kidney Calculi Diseases 0.000 description 1
- 206010029148 Nephrolithiasis Diseases 0.000 description 1
- 208000027418 Wounds and injury Diseases 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 238000009434 installation Methods 0.000 description 1
- 238000011017 operating method Methods 0.000 description 1
- 239000013307 optical fiber Substances 0.000 description 1
- 238000011084 recovery Methods 0.000 description 1
Classifications
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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
- A61B1/307—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 for the urinary organs, e.g. urethroscopes, cystoscopes
-
- 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
- A61B1/00064—Constructional details of the endoscope body
-
- 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
- A61B1/00131—Accessories for endoscopes
-
- 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
- A61B1/00147—Holding or positioning arrangements
- A61B1/00154—Holding or positioning arrangements using guiding arrangements for insertion
-
- 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
- A61B1/005—Flexible endoscopes
-
- 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
- A61B1/005—Flexible endoscopes
- A61B1/01—Guiding arrangements therefore
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
- A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
- A61B18/26—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor for producing a shock wave, e.g. laser lithotripsy
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00505—Urinary tract
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00982—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
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Abstract
The invention relates to a ureter soft-mirror diagnosis and treatment method and a device with an integrated guide sheath, which are characterized in that a detachable hard tube is arranged, A hard connection with mechanical strength is established between the ureteral soft lens and the guiding sheath, so that a handle of the ureteral soft lens can be conveniently held and controlled. The ureteral soft mirror handle and the tail end fixing part of the guiding sheath can be combined into a whole, and the guiding sheath can be conveniently inserted by pushing the ureteral soft mirror handle. The operation process does not need to use a cystoscope additionally, so that the operation steps are simplified, the operation time is saved, the operation cost is reduced, and the operation risk is reduced.
Description
Technical Field
The invention relates to medical equipment, in particular to a ureter soft-mirror diagnosis and treatment method integrating a guide sheath and an integrated medical device for realizing ureter soft-mirror diagnosis and treatment by adopting the method.
Background
Ureteroscope is a thin lens with a diameter of about 3mm, passes through urethra, bladder and ureter, and enters kidney, and ureter calculus or kidney calculus is smashed and taken out by using laser optical fiber or other tools in working channel. The non-invasive or minimally invasive endoscopic surgery uses the natural cavity of the urinary system of a human body, does not make any incision on the body, and is a non-invasive or minimally invasive endoscopic surgery for urinary surgery. Compared with open operation, ureteroscope lithotripsy has the advantages of small injury, light pain, quick recovery, and the like. Soft-mirror surgery, however, requires a high level of skill from the physician.
The existing ureteroscope needs a plurality of steps to finish when entering the urinary system:
step 1, inserting a flexible guide wire (with the diameter of 0.5 mm) into the urethra and entering the bladder;
Step 2: using a cystoscope, finding an inlet of a left ureter or a right ureter in the inner cavity of the bladder, and leading a guide wire to enter the left ureter or the right ureter through a working channel of the cystoscope;
Step 3, inserting a guide sheath into the tail end of the guide wire, sequentially entering the guide sheath and the guide sheath inner core into the urethra, the bladder and the ureter along the guide wire, and placing;
step 4, extracting the guide wire and the inner core of the guide sheath;
Step 5, the ureteral soft lens extends out of the head of the guiding sheath along the inner cavity of the guiding sheath and enters the ureter and the kidney;
step 6, searching and determining the position of the stone by using a ureteroscope, and stretching the working channel of the ureteroscope into a laser fiber for stone breaking operation or stretching the ureteroscope into a stone-taking basket for stone taking operation; repeating the step 4 and the step 5 until the process is completed;
After the operation is finished, the ureteroscope is withdrawn out of the human body along the guiding sheath, and then the guiding sheath is withdrawn from the human body.
In the above-described procedure, an additional cystoscope is required in order for the guide wire to find the left ureter entrance or the right ureter entrance. Thus, the cost and time to use the cystoscope is increased. But without the use of cystoscopes, the time to find the left and right ureter entrances is increased during the guide wire insertion procedure, and the risk of the guide wire stabbing the inner wall of the urinary system is increased.
Disclosure of Invention
The technical problems to be solved by the invention are as follows: the ureter soft-mirror diagnosis and treatment method with the integrated guide sheath has the advantages that only one ureter soft mirror is needed, no additional cystoscope is needed for guiding, the setting work before the ureter soft-mirror operation can be completed, the operation process is quickened, the operation time is saved, and the operation cost of a patient is reduced.
In addition, the invention also provides a ureteroscope device adopting the diagnosis and treatment method and integrating the guide sheath.
The invention solves the problems by adopting the technical scheme that: a ureteroscope diagnosis and treatment method integrating a guiding sheath is characterized by comprising the following steps of:
The method comprises the following steps:
The preparation stage:
step 1: integrating a ureteral soft lens insertion tube into the guide sheath;
step 2: the tail end of the detachable hard tube is fixed with the control handle of the ureteroscope, and the head part of the detachable hard tube is locked with the fixing part at the tail end of the guiding sheath to form a whole which can be operated cooperatively;
step 3: introducing and placing a guide wire into a working channel of the ureteral soft lens;
Surgical stage:
Step 4: under the monitoring of a ureteroscope, a doctor enters a guide wire and a guide sheath into the urethra of a patient, and enters the bladder along the urethra, so as to find an inlet of a left ureter or an inlet of a right ureter and enter the left ureter or the right ureter;
Step 5: the doctor removes the detachable hard tube, releases the guiding sheath, and detains the guiding sheath in the urinary system to form a passage from the urethra to the left or right ureter;
step 6: the guide wire is drawn out from the working channel of the ureteral soft lens and exits from the human body;
Step 7: and searching and determining the position of the stone by using a ureter soft lens, and stretching the working channel of the ureter soft lens into a laser fiber for stone breaking operation or stretching the ureter soft lens into a stone taking basket for stone taking operation.
The ureteroscope with the integrated guide sheath adopting the method is characterized in that: the ureteral soft endoscope comprises a guiding sheath, a fixing part, a detachable hard tube and a ureteral soft endoscope; the fixing part is arranged at the tail part of the guiding sheath; the detachable hard tube tail is provided with a conical trepanning, and the conical trepanning is fixedly connected with the handle of the ureter soft lens.
The detachable hard tube comprises an upper guide sheath connector and a lower guide sheath connector which can be mutually buckled.
An elastic buckle is arranged on the upper guide sheath connector, and the buckle can be matched with a bayonet in the fixing part.
Compared with the prior art, the invention adopts a mode of combining the guide sheath and the ureteroscope, replaces the original method of respectively inserting the cystoscope, the guide wire, the guide sheath and the ureteroscope into the urinary system, directly and conveniently enters the guide sheath fixedly connected with the ureteroscope into the urethra, the bladder and the ureter at one time without using the cystoscope, simplifies operation steps, saves operation time, reduces operation cost and reduces operation risk.
Can dismantle hard tube at the in-process that the guiding sheath inserted the urethra, can combine into whole with the tail end fixed part of guiding sheath soft mirror handle of ureter, through pushing the soft mirror handle of ureter, just can conveniently realize the operation of inserting of guiding sheath. When the ureter soft lens is required to further extend from the bladder to the ureter and the like, the detachable tube is directly separated, and the ureter soft lens can be pushed to obtain a proper flexible pushing distance by pushing the ureter soft lens handle when the fixing part is positioned at the urethral inlet, so that the ureter soft lens is beneficial to deep examination.
Drawings
Fig. 1 is a schematic view of a structure in which a detachable hard tube is integrally installed.
Fig. 2 is a schematic view of the structure of the detachable hard tube after separation.
Fig. 3 is a cross-sectional view of the removable hard tube after installation along the removable hard tube. (section view at B in FIG. 2).
Fig. 4 is a cross-sectional profile view of the removable hard tube after separation.
Wherein 1 is the guiding sheath, 2 is the fixed part, 3 is the detachable hard tube, 4 is the taper trepanning, 5 is the ureteroscope handle, 6 is the handle cable, 7 is the guiding sheath connector, 8 is the guiding sheath connector down.
Detailed Description
The invention is described in further detail below with reference to the accompanying drawings.
The invention directly adopts a mode of combining the guide sheath with the ureteroscope insertion tube, replaces the guide sheath inner core in the traditional ureteroscope technology by using the ureteroscope insertion tube, does not need to use an extra cystoscope to guide the guide wire and the guide sheath when in use, and can directly finish the process of entering the guide wire, the ureteroscope and the guide sheath into the urethra, the bladder and the ureter.
The ureteroscope entering kidney method comprises the following steps:
The preparation stage:
Step 1: integrating a ureteral soft-scope insertion tube within the introducer sheath (this sheath does not require an inner core);
Step 2: fixing the tail end of the detachable hard tube and the control handle of the ureteroscope, and locking the head part of the detachable hard tube and the fixing part of the tail end of the guiding sheath to form a whole capable of cooperating;
Step 3, guiding the guide wire into and placing the guide wire in a working channel of the ureteral soft lens;
Surgical stage:
Step 4: under the monitoring of a ureteroscope, a doctor enters a guide wire and a guide sheath into the urethra of a patient, and enters the bladder along the urethra, so as to find an inlet of a left ureter or an inlet of a right ureter and enter the left ureter or the right ureter;
Step 5: the doctor removes the detachable hard tube, releases the guiding sheath, and detains the guiding sheath in the urinary system to form a passage from the urethra to the left or right ureter;
step 6: the guide wire is drawn out from the working channel of the ureteral soft lens and exits from the human body;
And 7, searching and determining the position of the stone by using a ureteral soft lens, and stretching the working channel of the stone by using a laser fiber to carry out stone crushing operation or stretching the stone into a stone-taking basket to carry out stone taking operation. It does not need to use an additional cystoscope, and the whole process of entering the urethra, the bladder and entering the ureter and the kidney from the bladder is operated under the monitoring of the ureter soft lens, thereby being convenient for doctors to judge and avoiding damaging the inner wall tissues of the urinary system.
The diagnosis and treatment equipment adopting the diagnosis and treatment method consists of a guide sheath, a fixing part, a detachable hard tube and a ureter soft lens.
The tail part of the guiding sheath is provided with a fixing part, and a bayonet is arranged in the fixing part.
The detachable hard tube comprises an upper guide sheath connector and a lower guide sheath connector which can be mutually buckled. The upper guide sheath connector is provided with an elastic buckle, the elastic buckle is matched with the bayonet of the fixing part, the buckle is restored by utilizing self elasticity after being inserted into the bayonet, and the fixing part is barbed to prevent the detachable hard tube and the guide sheath from loosening.
The detachable hard tube tail is provided with the toper trepanning, and toper trepanning is connected with the control handle of ureter soft lens, can fix the front portion of control handle, makes guiding sheath, detachable hard tube, control handle constitute a whole, and convenient operation ureter soft lens insert tube gets into in the urethra.
The length of the detachable hard tube is determined by subtracting the length of the guiding sheath from the length of the ureteral soft lens insertion tube. The length and diameter of the guide sheath are of different specifications, which vary from person to person.
After the guiding sheath is completely inserted and placed, a protection channel from the urethral orifice to the ureter of a patient can be established, and the insertion tube containing the ureter soft lens can not directly rub and damage the inner wall in the process of extending into the urethra, the bladder, the ureter and the kidney for many times.
After the detachable hard tube is removed, the insertion tube originally fixed between the tail part of the guide sheath and the ureter soft lens handle is released, and the ureter soft lens insertion tube can be continuously pushed to further extend into the ureter and the kidney.
The invention adopts a method of integrating the guide sheath and the ureteroscope into a whole, replaces the original method of respectively inserting the cystoscope, the guide wire, the guide sheath and the ureteroscope into the urinary system, and can better guide the guide wire and the guide sheath to enter the bladder and the ureter along the urethra by utilizing the ureteroscope; through setting up detachable hard tube, connect guide sheath and soft mirror control handle into a whole, doctor can hold the handle and directly carry out the operation of inserting of guide wire, guide sheath, and it need not to use the cystoscope in addition, has simplified operating procedure, has practiced thrift operation time, has reduced operation cost, has reduced the operation risk.
Claims (1)
1. The ureter integrated with the guide sheath is characterized by comprising the guide sheath, a fixing part, a detachable hard tube and a ureter soft lens; the fixing part is arranged at the tail part of the guide sheath, the detachable hard tube is formed by mutually buckling an upper guide sheath connector and a lower guide sheath connector, and an elastic buckle is arranged on the upper guide sheath connector and is matched with a bayonet in the fixing part; the utility model discloses a ureter soft lens, including fixed part, detachable hard tube head, flexible ureteroscope, guiding sheath, detachable hard tube head with the fixed part is connected, detachable hard tube afterbody is provided with the toper trepanning, and this toper trepanning forms fixed connection with the control end of flexible ureteroscope, the inserted tube integration of flexible ureteroscope is in the guiding sheath, the length of detachable hard tube subtracts the length decision of guiding sheath according to the length of flexible ureteroscope inserted tube.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201911263657.6A CN110897601B (en) | 2019-12-11 | 2019-12-11 | Ureter soft-lens diagnosis and treatment method and device integrated with guide sheath |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201911263657.6A CN110897601B (en) | 2019-12-11 | 2019-12-11 | Ureter soft-lens diagnosis and treatment method and device integrated with guide sheath |
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| Publication Number | Publication Date |
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| CN110897601A CN110897601A (en) | 2020-03-24 |
| CN110897601B true CN110897601B (en) | 2024-10-11 |
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Families Citing this family (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN113257097A (en) * | 2021-05-18 | 2021-08-13 | 首都医科大学附属北京友谊医院 | Ureter hard/soft lens teaching mold and preparation and operation methods thereof |
| CN114869461A (en) * | 2022-03-30 | 2022-08-09 | 上海璞跃医疗器械有限公司 | A kind of stone crushing system and operation method for urinary calculi |
| CN115299867B (en) * | 2022-08-22 | 2024-09-27 | 广州兰韵医疗科技有限公司 | Electronic ureteroscope capable of measuring temperature in real time |
| CN118304000B (en) * | 2024-04-08 | 2025-09-30 | 福州大学 | A ureteroscopic surgical robot with multi-instrument collaborative operation |
| CN119564328B (en) * | 2025-01-02 | 2025-10-31 | 深圳科思明德医疗科技有限公司 | Nipple cutting system |
Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN208641514U (en) * | 2018-04-02 | 2019-03-26 | 深圳市恒海医疗科技有限公司 | Visual merging ureter sheath |
| CN212816204U (en) * | 2019-12-11 | 2021-03-30 | 宁波智光机电科技有限公司 | Ureter soft lens integrated with guide sheath |
Family Cites Families (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN102068232B (en) * | 2011-01-28 | 2013-04-10 | 周均洪 | Combined rigid ureteroscope |
| CN203943735U (en) * | 2014-04-10 | 2014-11-19 | 广州医科大学附属第一医院 | A kind of ureter soft lens channel sheath with scale |
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Patent Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN208641514U (en) * | 2018-04-02 | 2019-03-26 | 深圳市恒海医疗科技有限公司 | Visual merging ureter sheath |
| CN212816204U (en) * | 2019-12-11 | 2021-03-30 | 宁波智光机电科技有限公司 | Ureter soft lens integrated with guide sheath |
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