CN111528989A - 一种十二指肠镜用取石水刀碎石网篮 - Google Patents

一种十二指肠镜用取石水刀碎石网篮 Download PDF

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CN111528989A
CN111528989A CN202010273393.9A CN202010273393A CN111528989A CN 111528989 A CN111528989 A CN 111528989A CN 202010273393 A CN202010273393 A CN 202010273393A CN 111528989 A CN111528989 A CN 111528989A
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宋玲玲
张�诚
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    • 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
    • A61B2017/2212—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having a closed distal end, e.g. a loop
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
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Abstract

一种十二指肠镜用取石水刀碎石网篮属于医疗器械制造技术领域。本装置由刀头、管体和网篮构成。刀头为镍钛合金，呈柱形，内设有注水通道和网篮丝通道，上面呈弧形凹面上的出水孔呈环形排列，网篮丝通道开口于头端侧壁上，内有4根网篮钢丝；底面中央为弧形凹面，凹面上设有环形排列的进水孔和4个网篮丝孔。管体为单通道管，管内有网篮连杆和高压水管穿过，网篮连杆与网篮钢丝相连，高压水管分为两层，内层为铝镁合金管，外层为螺旋状缠绕在铝镁合金管外的钢丝管。连接头为单通道管硬质钢管，管壁外设有螺旋，与高压水管相通。本发明的优点是，适合所有结石的碎石、能够使结石固定、促进碎石的排出、增加安全性。

Description

一种十二指肠镜用取石水刀碎石网篮
技术领域
本发明属于医疗器械制造技术领域，涉及一种微创医疗技术及手术器械，用于十二指肠镜下取石及碎石的器械，具体地说是一种十二指肠镜用取石水刀碎石网篮。
背景技术
胆总管结石是我国的常见病和多发病，结石堵塞胆总管长诱发急性胆管炎、梗阻性黄疸、急性胆源性胰腺炎等并发症，出现寒战、发热、腹痛、黄疸等表现，重者甚至导致休克，长期的结石刺激有发生胆管癌的风险，是危害人类健康的重要疾病。没权胆总管结石的治疗方案包括开腹胆道探查取石、腹腔镜胆道探查取石、内镜逆行胰胆管造影(ERCP)取石、经皮经肝胆管穿刺(PTCD)+瘘道扩张+经皮经肝胆道镜(PTCS)取石、经PTCD途径十二指肠乳头球囊扩张囊取石等。
对于高龄、基础疾病多、心肺功能障碍等不适合行全麻胆道探查手术的患者多采取ERCP取石，先进行乳头括约肌切开及球囊扩张，然后使用取石球囊将结石拖入胆总管内，但是对于直径超过1.5cm的巨大胆总管结石，采取的ERCP辅助的网篮机械取石或SpyGlass直视下碎石。上述技术头端存在以下不足：1.完整取出结石前长采取乳头括约肌大切开及大球囊乳头扩张风险较大，围手术期容易发生乳头出血、急性胰腺炎、穿孔等近期并发症并发症，以及反流性胆管炎、结石早期复发及胆管炎等远期并发症；2.巨大胆总管结石往往引起胆总管梗阻，由于空间狭窄，经ERCP置入碎石网篮难以套取巨大胆总管结石；3.网篮机械碎石效率低，部分坚硬的胆固醇结石难以被网篮勒碎；4.套取结石后如不能勒碎结石，如果结石不能经网篮排出，导致碎石网篮不能取出，只能选择全麻胆道探查手术，其风险大；5.经ERCP置入SpyGlass直视下碎石是近期开展的新技术，其碎石效率较高，且并发症低，但是SpyGlass仪器及耗材费用极高，普通医院并未开展该项技术，普通家庭难以承受其巨额高额的治疗费用。
水刀，即高压水射流切割技术，压力高于200Mpa的水刀被广泛应用于陶瓷、石材、剥离、金属、符合材料等硬质材料的切割，泡沫、纸、内饰物等软性材料切割，污染物的清除等。随着技术的发展，出现了便携式的低压水刀，工作压力为25-50Mpa。与激光切割和等离子切割相比，水刀属于冷态切割，无明显热效应，适合任何材质的打孔、切割。
发明内容
本发明的目的就是提供一种适合所有结石的碎石、促进碎石的排出、增加安全性、能够使结石固定的十二指肠镜用取石水刀碎石网篮。
本发明装置由刀头1、管体2和网篮3构成，其中，
a.刀头1呈柱形，内设有注水通道4和网篮丝通道7，顶面上的出水孔5与注水通道4相通，网篮丝通道7开口于刀头1头端外壁上，穿过网篮丝通道7的网篮丝6构成网篮3；底面设有进水孔8和网篮丝孔9；
b.与刀头1连接的管体2为单通道管，内部设置的通道10内有网篮连杆11和高压水管12穿过，网篮连杆11与网篮丝6相连接，高压水管12上端与进水孔8相通连接；管体2的尾部16设置的连接头13为单通道管，管壁外设有螺旋，与高压水管12下端相通；
刀头1长度1cm，外径8.5Fr，4-13条注水通道4直径0.3mm，出水孔5向内侧出水角度α是30-60°，网篮丝6直径0.5mm；网篮丝通道7内径2Fr；
刀头1为镍钛合金，呈柱形，呈弧形凹面的顶面上的出水孔5呈环形排列，网篮丝6是钢丝；呈弧形凹面的底面上设有网篮丝孔9和呈环形排列的进水孔8；
网篮丝6是4根钢丝，网篮丝孔9是4个；
聚乙烯材质的管体2的尾部16设置的连接头13为单通道管钢管，高压水管12分为两层，内层为铝镁合金管，外层为螺旋状缠绕在铝镁合金管外的钢丝管；尾部16外壁包有硬塑料管；
管体2长250cm，外径8.5Fr，内径6Fr，其中，尾部16长10cm，外径10Fr，内径6Fr；尾部16网篮连杆11长30cm，直径1.5mm；高压水管12外径6Fr，内径4Fr；网篮3释放直径3-4cm。
本发明所达到的有益效果是：
1.本发明适合胆固醇结石、胆色素结石、混合结石等所有结石的碎石；
2.本发发明在进行碎石的同时，能够对视野进行冲洗，促进碎石的排出。
3.本发明的头端高速水流汇聚于一点，发挥最大的碎石效果，水流汇聚后速度明显减慢，增加了碎石的安全性。
4.本发明网篮套取结石后，收紧网篮，能够使结石固定，并紧贴导管头端的水刀刀头上。
附图说明
图1是本发明的结构示意图，
图2是本发明中的刀头放大示意图，
图3是本发明的刀头的俯视放大示意图，
图4是本发明的张开网篮套取胆总管结石的结构示意图，
图5是本发明的接通水刀击碎结石的结构示意图，
1.刀头，2.管体，3.网篮，4.注水通道，5.出水孔，6.网篮丝，7.网篮丝通道，8.进水孔，9.网篮丝孔，10.通道，11.网篮连杆，12.高压水管，13.连接头，14.水流聚焦点，15.高速水流，16.尾部，17.结石，18.结石，α.出水角。
具体实施方式
下面结合附图和具体实施方式对本发明作进一步的说明。
本发明装置由刀头1、管体2和网篮3构成，其中，
a.刀头1为镍钛合金，呈柱形，长度1cm，外径8.5Fr，内设有13条呈L型的直径0.3mm的注水通道4和网篮丝通道7，顶面呈弧形凹面，凹面上的的出水孔5与注水通道4相通呈环形排列，出水孔5向内侧出水角度α是40°，经出水孔5射出的高速水流呈放射状汇聚于一点14，内径2Fr的网篮丝通道7开口于刀头1头端外壁上，穿过网篮丝通道7的4根直径0.5mm的钢网篮丝6构成网篮3；底面中央为弧形凹面，凹面上设有环形排列的进水孔8和4个网篮丝孔9；
b.与刀头1连接的聚乙烯管体2为单通道管，长250cm，外径8.5Fr，内径6Fr，内部设置的通道10内有网篮连杆11和高压水管12穿过，网篮连杆11与网篮钢丝6相连接，高压水管12上端与进水孔8相通连接，高压水管12分为两层，内层为铝镁合金管，外层为螺旋状缠绕在铝镁合金管外的钢丝管；管体2尾部16设置的连接头13为单通道管钢管，管壁外设有螺旋，与高压管12下端相通；尾部16外壁包有硬塑料管；尾部16长10cm，外径10Fr，内径6Fr；网篮连杆11长30cm，直径1.5mm；高压水管12外径6Fr，内径4Fr；网篮3释放直径3cm。
经口置入十二指肠镜，胆管插管成功后，先行内镜逆行胆管造影，确定结石的数目、部位及大小，再行十二指肠乳头括约肌小切开，并使用直径1.0cm的柱形球囊扩张十二指肠乳头。
在导丝引导下经十二指肠钳道置入本装置，释放网篮3并套取胆总管较小的结石直接拖入十二指肠。结石直径超过1cm时，释放本网篮3套取结石17，收紧网篮时结石贴近导管头端，行水刀碎石，将胆总管内大块结石击碎。
结石破碎后，释放网篮3套取结石18，将大块碎石拖入十二指肠，较小的碎石使用取石球囊拖入十二指肠。

Claims (6)

1.一种十二指肠镜用取石水刀碎石网篮，其特征在于，由刀头(1)、管体(2)和网篮(3)构成，其中，
a.刀头(1)呈柱形，内设有注水通道(4)和网篮丝通道(7)，顶面上的出水孔(5)与注水通道(4)相通，网篮丝通道(7)开口于刀头(1)头端外壁上，穿过网篮丝通道(7)的网篮丝(6)构成网篮(3)；底面设有进水孔(8)和网篮丝孔(9)；
b.与刀头(1)连接的管体(2)为单通道管，内部设置的通道(10)内有网篮连杆(11)和高压水管(12)穿过，网篮连杆(11)与网篮丝(6)相连接，高压水管(12)上端与进水孔(8)相通连接；管体(2)的尾部(16)设置的连接头(13)为单通道管，管壁外设有螺旋，与高压水管(12)下端相通。
2.根据权利要求1所述的一种十二指肠镜用取石水刀碎石网篮，其特征在于，刀头(1)长度1cm，外径8.5Fr，4-13条注水通道(4)直径0.3mm，出水孔(5)向内侧出水角度α是30-60°，网篮丝(6)直径0.5mm；网篮丝通道(7)内径2Fr。
3.根据权利要求1或2所述的一种十二指肠镜用取石水刀碎石网篮，其特征在于，刀头(1)为镍钛合金，呈柱形，呈弧形凹面的顶面上的出水孔(5)呈环形排列，网篮丝(6)是钢丝；呈弧形凹面的底面上设有网篮丝孔(9)和呈环形排列的进水孔(8)。
4.根据权利要求3所述的一种十二指肠镜用取石水刀碎石网篮，其特征在于，网篮丝(6)是4根钢丝，网篮丝孔(9)是4个。
5.根据权利要求1所述的一种十二指肠镜用取石水刀碎石网篮，其特征在于，聚乙烯材质的管体(2)的尾部(16)设置的连接头(13)为单通道管钢管，高压水管(12)分为两层，内层为铝镁合金管，外层为螺旋状缠绕在铝镁合金管外的钢丝管；尾部(16)外壁包有硬塑料管。
6.根据权利要求1或2所述的一种十二指肠镜用取石水刀碎石网篮，其特征在于，管体(2)长250cm，外径8.5Fr，内径6Fr，其中，尾部(16)长10cm，外径10Fr，内径6Fr；尾部(16)网篮连杆(11)长30cm，直径1.5mm；高压水管(12)外径6Fr，内径4Fr；网篮(3)释放直径3-4cm。
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CN113143402A (zh) * 2021-04-02 2021-07-23 台州浩欣医疗科技有限公司 分层式取物导管

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN113143402A (zh) * 2021-04-02 2021-07-23 台州浩欣医疗科技有限公司 分层式取物导管
CN113143402B (zh) * 2021-04-02 2022-06-24 台州浩欣医疗科技有限公司 分层式取物导管

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