CN111419150A - 单孔免气腹胆道镜鞘管 - Google Patents

单孔免气腹胆道镜鞘管 Download PDF

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CN111419150A
CN111419150A CN202010222626.2A CN202010222626A CN111419150A CN 111419150 A CN111419150 A CN 111419150A CN 202010222626 A CN202010222626 A CN 202010222626A CN 111419150 A CN111419150 A CN 111419150A
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choledochoscope
laparoscope
pneumoperitoneum
tube
free
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宋玲玲
张�诚
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Affiliated Zhongshan Hospital of Dalian University
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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
    • A61B1/313—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 introducing through surgical openings, e.g. laparoscopes
    • A61B1/3132—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 introducing through surgical openings, e.g. laparoscopes for laparoscopy
    • 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
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, 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
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22038—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22038—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
    • A61B2017/22042—Details of the tip of the guide wire
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22072—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an instrument channel, e.g. for replacing one instrument by the other

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Abstract

本发明提供一种单孔免气腹胆道镜鞘管，其特征在于：包括胆道镜通道管、腹腔镜固定环；所述的胆道镜通道管的管壁外接有腹腔镜固定环；所述的胆道镜通道管外径为1cm或0.5cm、长40cm；所述的腹腔镜固定环有三个，等距设置于胆道镜通道管同一侧面，外径为1cm、内径为0.7cm。具有操作更为简单等优点，使腹腔镜联合胆道镜的单孔免气腹保胆手术得以实现。

Description

单孔免气腹胆道镜鞘管
技术领域
本发明涉及一种胆道镜鞘管，特别是关于一种单孔免气腹胆道镜鞘管。
背景技术
胆囊是人体重要的消化器官，随着人们对胆囊功能的重视及保护，保胆取石手术孕育而生。手术方式逐渐从传统的右上腹小切口保胆手术，经历腹腔镜辅助右上腹小切口保胆手术，演变为现在的完全腹腔镜保胆手术。完全腹腔镜保胆多采取三孔或双孔应到，腹腔镜经肚脐戳卡腔道进入腹腔，胆道镜则通过右上腹戳卡通道进入。腹腔镜直视下，术者左手持镜，通过调节右上腹戳卡方向，使胆道镜以最短的距离进入胆囊内，右手操作取石网篮等附件，进行取石、切除息肉、罗-阿氏窦切开等操作。套取结石后，助手左手持胆道镜并退出胆道镜，右手持腹腔镜，由于腹腔镜与胆道镜不同步，难以做到腹腔镜视野下退出胆道镜，即使胆道镜头端结石脱落，往往也难以发现。
随着人们对微创技术的要求越来越高，单孔腹腔镜技术逐渐应用于临床，其中单孔腹腔镜胆囊切除术开展最为广泛，但是单孔腹腔镜保胆手术的发展较为缓慢。因为肚脐切口距离胆囊距离较远，胆道镜为软镜，在置入过程中镜身缺少支撑，因此经脐置入胆道镜进入胆囊时间较长，胆道镜在胆囊内难以调节方向，因此胆道镜观察和治疗均较困难。
常规单孔腹腔镜需要往腹腔持续注入二氧化碳，充盈腹腔，以显露手术视野。腹腔压力的升高直接限制膈肌的活动，影响患者心肺功能，腹腔镜术后容易出现肩部疼痛及恶心症状，此外如果发生静脉出血，二氧化碳经血管切口回流，容易发生气体栓塞。在这种背景下，出现了免气腹腹腔镜手术，传统免气腹手术采取悬吊腹壁的方式进行，此种方式对腹壁损伤较大，临床推广困难，目前已较少使用。程国庆发明了一种免气腹单孔微创术野生成系统(专利号：ZL201620471905.1、ZL201620472279.8)，通过肚脐切口置入该装置，无需往腹腔灌注二氧化碳，就可以显露肚脐至胆囊的空间，目前已经进入临床。与其它腹腔镜技术相比，使用该装置可实现单孔免气腹胆囊切除术，但是难以完成腹腔镜联合胆道镜保胆手术，因为经该装置置入胆道镜缺少支撑。
发明内容
为解决现有技术中存在的缺陷，本发明提供一种单孔免气腹胆道镜鞘管。
本发明的技术解决方案是：一种单孔免气腹胆道镜鞘管，其特征在于：包括胆道镜通道管和腹腔镜固定环；
所述的胆道镜通道管的管壁外接有腹腔镜固定环；
所述的胆道镜通道管外径为1cm或0.5cm、长40cm；
所述的腹腔镜固定环有三个，等距设置于胆道镜通道管同一侧面，外径为1cm、内径为0.7cm。
本发明同现有技术相比具有以下优点：
1.使腹腔镜联合胆道镜的单孔免气腹保胆手术得以实现；
2.通过本发明置入胆道镜更容易进入胆囊内；
3.通过本发明的支撑，胆道镜更容易在胆囊内调整方向；
4.通过本发明实现胆道镜与腹腔镜的同步运动，可在腹腔镜监视下完成取石、送入取石袋等操作；
5.右手移动腹腔镜的同时可移动胆道镜，无需左手的帮助，操作更为简单。
附图说明
图1是本发明的示意图。
图2是本发明的使用示意图。
图中：1、胆道镜通道管，2、腹腔镜固定环，3、腹腔镜，4、胆道镜，5、腹壁，6、胆囊，7、单通道免气腹装置。
具体实施方式
胆道镜通道管1和腹腔镜固定环2由硅胶加工而成，胆道镜通道管1外径为1cm或0.5cm、长40cm，腹腔镜固定环2有三个，等距设置于胆道镜通道管1同一侧面，外径为1cm、内径为0.7cm。
使用时将腹腔镜3依次通过三个腹腔镜固定环2，将本发明固定在腹腔镜3镜身上，经单通道免气腹装置7穿过腹壁5置入腹腔，腹腔镜3头端到达胆囊6切口处，再进经胆道镜通道管1置入胆道镜4，胆道镜4经胆道镜通道管1出口引出时靠近胆囊6切口，可轻松进入胆囊6内，在腹腔镜3和本发明的引导下，胆道镜4镜身更容易固定，头端镜身改变角度时，其支撑作用更容易改变胆道镜4方向；套取结石或切除息肉过程中，术者左手持胆道镜4，右手操作取石网篮、圈套器等胆道镜4附件，助手通过进出腹腔镜3，可调节胆道镜4的前进和后退，胆道镜4视野与腹腔镜3视野同步，取出腹腔镜3的同时，可在腹腔镜3视野下取出胆道镜4、胆道镜4头端套取的结石。

Claims (1)

1.一种单孔免气腹胆道镜鞘管，其特征在于：包括胆道镜通道管(1)、腹腔镜固定环(2)；
所述的胆道镜通道管(1)的管壁外接有腹腔镜固定环(2)；
所述的胆道镜通道管(1)外径为1cm或0.5cm、长40cm；
所述的腹腔镜固定环(2)有三个，等距设置于胆道镜通道管(1)同一侧面，外径为1cm、内径为0.7cm。
CN202010222626.2A 2020-03-26 2020-03-26 单孔免气腹胆道镜鞘管 Withdrawn CN111419150A (zh)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111803019A (zh) * 2020-08-05 2020-10-23 上海市东方医院（同济大学附属东方医院） 免气腹单孔腹腔镜及胆道镜保护鞘管及其应用

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111803019A (zh) * 2020-08-05 2020-10-23 上海市东方医院（同济大学附属东方医院） 免气腹单孔腹腔镜及胆道镜保护鞘管及其应用
CN111803019B (zh) * 2020-08-05 2024-05-07 上海市东方医院（同济大学附属东方医院） 免气腹单孔腹腔镜及胆道镜保护鞘管及其应用

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