CN111671475A - 一种具有滑动扩张鞘的内窥镜 - Google Patents

一种具有滑动扩张鞘的内窥镜 Download PDF

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CN111671475A
CN111671475A CN202010621009.XA CN202010621009A CN111671475A CN 111671475 A CN111671475 A CN 111671475A CN 202010621009 A CN202010621009 A CN 202010621009A CN 111671475 A CN111671475 A CN 111671475A
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puncture needle
expansion
endoscope
sliding
tube
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胡学成
李建兴
张瑶
毛业云
龙刚
秦操
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Youcare Technology Co ltd Wuhan
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Abstract

本发明公开了一种具有滑动扩张鞘的内窥镜，包括内窥镜手柄和穿刺针管，穿刺针管的头端同轴固定于内窥镜手柄内，内窥镜手柄内沿其轴向开设有与穿刺针管同轴连通的图像照明装置通道，内窥镜手柄上固定有与图像照明装置通道同轴连通的图像照明装置接头；穿刺针管设置于滑动扩张鞘内，滑动扩张鞘包括与穿刺针管的轴向平行并与穿刺针管滑动配合的扩张管，穿刺针管设置于扩张管内，穿刺针管与扩张管之间存在间隙。本发明所述的内窥镜结构简单、使用方便，在人体腔内进行病变组织探查和诊断后，可对病变组织碎除、治疗，同时在手术过程中可防止腔内压力过大。

Description

一种具有滑动扩张鞘的内窥镜
技术领域
本发明涉及微创医疗器械技术领域，具体地指一种具有滑动扩张鞘的内窥镜。
背景技术
目前微创手术因其具有减少患者痛苦、有利恢复、外表美观、缩短住院时间、减少费用等优势，已广泛应用与泌尿外科、骨科、妇科、普外科、胸外科、病理、眼科科等科室。现阶段在泌尿外科领域治疗肾结石，普遍使用经皮肾镜取石手术，这种手术具有创口小、对肾脏及周围组织损伤小、痛苦轻、治疗周期短、效果立竿见影、恢复快等优点。在临床上传统的经皮肾镜手术因穿刺进入肾脏时，手术操作者依靠手感、或在超声、CT等引导下预测深度来判断刺入部位，这些方法比较盲目、耗时，时有失误发生易造成以下问题。
1、在穿刺过程不能实时监控，容易穿破血管导致出血，致使手术不能进行；
2、穿刺结束后通过穿刺针管放入导丝至肾脏内，然后将扩张鞘沿导丝进行扩张，在扩张时不能观察扩张鞘行进的的位置，容易造成肾内出血，引起医疗事故或手术不能继续进行；
3、在经皮肾手术过程中发现肾内结石质地坚硬，需要采用碎石效率高的碎石器械，然而碎石效率越高碎石器械直径越大，当碎石器械直径过大，导致置入的扩张鞘腔道难以容下时，需重新穿入导丝，退出扩张鞘，重新置入腔道更大的扩张鞘，操作繁琐，增加手术时间；
4、在经皮肾手术中时有肾内压过高导致并发症。
发明内容
本发明的目的就是要解决上述背景技术的不足，提供一种穿刺精准、可实时监控穿刺位置，保证穿刺顺利的具有滑动扩张鞘的内窥镜。
为实现此目的，本发明所设计的具有滑动扩张鞘的内窥镜，包括内窥镜手柄和穿刺针管，其特征在于：所述穿刺针管的头端同轴固定于所述内窥镜手柄内，所述内窥镜手柄内沿其轴向开设有与所述穿刺针管同轴连通的图像照明装置通道，所述内窥镜手柄上固定有与所述图像照明装置通道同轴连通的图像照明装置接头；所述穿刺针管设置于滑动扩张鞘内，所述滑动扩张鞘包括与所述穿刺针管的轴向平行并与所述穿刺针管滑动配合的扩张管，所述穿刺针管设置于所述扩张管内，所述穿刺针管与所述扩张管之间存在间隙。
进一步的，所述滑动扩张鞘还包括同轴固定于所述内窥镜手柄上的扩张鞘支架和可沿所述扩张鞘支架轴向滑动的滑块，所述滑块上固定有所述扩张管。
进一步的，所述滑块的侧部固定有与所述穿刺针管垂直连通的负压吸引接头。
进一步的，所述负压吸引接头内开设有与所述扩张管垂直连通的负压吸引通道，所述负压吸引接头的侧部开设有与所述负压吸引通道连通的排水孔。
进一步的，所述穿刺针管偏心设置于所述扩张管内。
进一步的，所述扩张管包括直径大于所述穿刺针管、头端固定于所述滑块内的扩张直管段和固定于所述扩张直管段尾端的锥台管段，所述穿刺针管的轴向与所述扩张直管段的轴向平行，所述穿刺针管偏心设置于所述锥台管段内。
进一步的，所述锥台管段的尾端内表面为与所述穿刺针管的径向截面外表面相切的圆形或椭圆形。
进一步的，所述锥台管段的侧壁上开有排石孔。
更进一步的，所述内窥镜手柄内还开设有与所述穿刺针管连通的注水通道和器械通道，所述内窥镜手柄上固定连接有与所述注水通道同轴连通的注水接头和与所述器械通道同轴连通的器械接头。
本发明的有益效果是：
1、本发明所述的内窥镜结构简单、使用方便：根据手术需求，滑动扩张鞘可以与穿刺针管和内窥镜手柄组合使用，图像照明装置插入穿刺针管内，调整图像照明装置插入针管内的深度来调节观察范围，并从注水接头注水，水流通过穿刺针管进入人体腔内并冲开镜头前的遮挡物，保证视野开阔、图像清晰。
2、在人体腔内进行病变组织探查和诊断后，对病变组织碎除、治疗：医生将扩张管推至穿刺口，利用扩张管前端的锥形管扩张穿刺口，使扩张管进入人体腔内，通过穿刺针管内的图像照明装置观察扩张管进入人体腔内的位置，确定好位置后，通过图像照明装置观察调整好穿刺针管与病变组织的相对位置，通过器械接头插入钬激光光纤，钬激光通过穿刺针管进入人体腔内，钬激光工作产生的热量通过注入人体腔内的水带走并经过扩张管从负压吸引接头流出。
3、在手术过程中防止腔内压力过大：可接负压吸器通过负压吸引接头控制腔内压力，同时由于扩张管内径大于穿刺针管外径，钬激光碎除的病变组织和水可在不改变穿刺针管位置的情况下，通过负压吸引接头和排水孔吸出体外。
附图说明
图1为本发明中具有滑动扩张鞘的内窥镜的立体图；
图2为本发明中具有滑动扩张鞘的内窥镜的主视图；
图3为本发明中具有滑动扩张鞘的内窥镜的右视图；
图4为图3中A-A剖视图；
图5为本发明中穿刺针管的立体图；
图6为本发明中扩张鞘支架的立体图；
图7为本发明中滑块连接扩张管和负压吸引接头的立体图；
图8为本发明中滑块连接扩张管和负压吸引接头的俯视图；
图9为本发明中滑块连接扩张管和负压吸引接头的主视图；
图10为图9中B-B剖视图；
其中，1—内窥镜手柄，2—穿刺针管，3—图像照明装置通道，4—图像照明装置接头，5—扩张管(5.1—扩张直管段，5.2—锥台管段)，6—扩张鞘支架，7—滑块，8—负压吸引接头，9—负压吸引通道，10—排水孔，11—注水通道，12—器械通道，13—注水接头，14—器械接头，15—穿刺针管支座，16—排石孔。
具体实施方式
下面结合附图和具体实施例对本发明作进一步的详细说明。
如图1—10所示的具有滑动扩张鞘的内窥镜，包括内窥镜手柄1和穿刺针管2，穿刺针管2的头端同轴固定有穿刺针管支座15，穿刺针管支座15同轴固定于内窥镜手柄1内，内窥镜手柄1内沿其轴向开设有与穿刺针管2同轴连通的图像照明装置通道3、与所述图像照明装置通道3不同轴但与穿刺针管2连通的注水通道11和器械通道12，内窥镜手柄1上固定有与图像照明装置通道3同轴连通的图像照明装置接头4、与注水通道11同轴连通的注水接头13和与器械通道12同轴连通的器械接头14。
滑动扩张鞘包括通过螺纹同轴固定于内窥镜手柄1上的扩张鞘支架6和可沿扩张鞘支架6轴向滑动的滑块7，滑块7上固定有扩张管5，滑块7的侧部固定有与穿刺针管2垂直连通的负压吸引接头8。负压吸引接头8内开设有与扩张管5垂直连通的负压吸引通道9，负压吸引接头8的侧部开设有与负压吸引通道9连通的排水孔10。
扩张管5包括直径大于穿刺针管2、头端固定于滑块7内的扩张直管段5.1和固定于扩张直管段5.1尾端的锥台管段5.2，锥台管段5.2的侧壁上开有排石孔16，被钬激光打碎的结石通过负压设备从排石孔16经扩张管5和负压吸引接头8排出。
穿刺针管2设置于扩张管5内：穿刺针管2的轴向与扩张直管段5.1的轴向平行，穿刺针管2偏心设置于锥台管段5.2内(锥台管段5.2的尾端内表面为与穿刺针管2的径向截面外表面相切的圆形或椭圆形)，锥台管段5.2的尾端内表面孔径大于穿刺针管2的径向截面外表面。
本发明中，滑动扩张鞘与内窥镜手柄1和穿刺针管2的组合结构简单、使用方便，具有可视穿刺和激光治疗两大功能：
可视穿刺取样：根据手术需求可从内窥镜手柄1内插入图像照明装置(如光纤镜)至穿刺针管2内，并从注水接头13注水通过冲开视野保证图像清晰，可探查腔内病变组织，对病变组织进行诊断，当探查到的病变组织需要取样活检，只需将扩张管5推入人体腔内，撤出穿刺针管2，将图像照明装置(如光纤镜)从穿刺针管2内取出，无需二次穿刺直接将取样针管通过扩张管5进入人体腔内，通过图像照明装置(如光纤镜)找到要取样位置进行取样。
激光治疗：人体腔内进行病变组织探查和诊断后，需要对病变组织碎除、治疗时，使扩张管5进入人体腔内，通过穿刺针管2内的图像照明装置(如光纤镜)观察扩张管进入人体腔内的位置，确定好位置后、通过图像照明装置(如光纤镜)观察调整好穿刺取样针管与病变组织的相对位置。通过内窥镜手柄1上的器械接头插入激光治疗器械(如钬激光光纤)，通过穿刺针管2进入人体腔内，钬激光工作产生的热量通过注入人体腔内的水带走并通过扩张管5与穿刺针管2的腔隙内并从排水孔10流出。在手术过程中为防止腔内压力过大，可接负压吸器调节腔内压力，同时钬激光碎除的病变组织可通过负压吸引接头8吸出体外。
以上所述，仅是本发明的较佳实施例而已，并非对本发明的结构做任何形式上的限制。凡是依据本发明的技术实质对以上实施例所作的任何简单修改、等同变化与修饰，均仍属于本发明的技术方案的范围内。

Claims (9)

1.一种具有滑动扩张鞘的内窥镜，包括内窥镜手柄(1)和穿刺针管(2)，其特征在于：所述穿刺针管(2)的头端同轴固定于所述内窥镜手柄(1)内，所述内窥镜手柄(1)内沿其轴向开设有与所述穿刺针管(2)同轴连通的图像照明装置通道(3)，所述内窥镜手柄(1)上固定有与所述图像照明装置通道(3)同轴连通的图像照明装置接头(4)；所述穿刺针管(2)设置于滑动扩张鞘内，所述滑动扩张鞘包括与所述穿刺针管(2)的轴向平行并与所述穿刺针管(2)滑动配合的扩张管(5)，所述穿刺针管(2)设置于所述扩张管(5)内，所述穿刺针管(2)与所述扩张管(5)之间存在间隙。
2.如权利要求1所述的具有滑动扩张鞘的内窥镜，其特征在于：所述滑动扩张鞘还包括同轴固定于所述内窥镜手柄(1)上的扩张鞘支架(6)和可沿所述扩张鞘支架(6)轴向滑动的滑块(7)，所述滑块(7)上固定有所述扩张管(5)。
3.如权利要求2所述的具有滑动扩张鞘的内窥镜，其特征在于：所述滑块(7)的侧部固定有与所述穿刺针管(2)垂直连通的负压吸引接头(8)。
4.如权利要求3所述的具有滑动扩张鞘的内窥镜，其特征在于：所述负压吸引接头(8)内开设有与所述扩张管(5)垂直连通的负压吸引通道(9)，所述负压吸引接头(8)的侧部开设有与所述负压吸引通道(9)连通的排水孔(10)。
5.如权利要求1所述的具有滑动扩张鞘的内窥镜，其特征在于：所述穿刺针管(2)偏心设置于所述扩张管(5)内。
6.如权利要求5所述的具有滑动扩张鞘的内窥镜，其特征在于：所述扩张管(5)包括直径大于所述穿刺针管(2)、头端固定于所述滑块(7)内的扩张直管段(5.1)和固定于所述扩张直管段(5.1)尾端的锥台管段(5.2)，所述穿刺针管(2)的轴向与所述扩张直管段(5.1)的轴向平行，所述穿刺针管(2)偏心设置于所述锥台管段(5.2)内。
7.如权利要求6所述的具有滑动扩张鞘的内窥镜，其特征在于：所述锥台管段(5.2)的尾端内表面与所述穿刺针管(2)的径向截面外表面相切的圆形或椭圆形。
8.如权利要求6所述的具有滑动扩张鞘的内窥镜，其特征在于：所述锥台管段(5.2)的侧壁上开有排石孔(16)。
9.如权利要求1所述的具有滑动扩张鞘的内窥镜，其特征在于：所述内窥镜手柄(1)内还开设有与所述穿刺针管(2)连通的注水通道(11)和器械通道(12)，所述内窥镜手柄(1)上固定连接有与所述注水通道(11)同轴连通的注水接头(13)和与所述器械通道(12)同轴连通的器械接头(14)。
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Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN112137661A (zh) * 2020-11-26 2020-12-29 珠海维尔康生物科技有限公司 一种可视扩张鞘
CN112604144A (zh) * 2020-12-21 2021-04-06 张春林 3d打印阴道多通道模型塞施源器
CN113425384A (zh) * 2021-05-19 2021-09-24 北京华腾创新科技有限公司 一种多功能穿刺装置
CN113509221A (zh) * 2021-07-05 2021-10-19 江西医为特科技有限公司 一种带有自动液压监控功能的内窥镜手术系统

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN112137661A (zh) * 2020-11-26 2020-12-29 珠海维尔康生物科技有限公司 一种可视扩张鞘
CN112137661B (zh) * 2020-11-26 2021-03-19 珠海维尔康生物科技有限公司 一种可视扩张鞘
CN112604144A (zh) * 2020-12-21 2021-04-06 张春林 3d打印阴道多通道模型塞施源器
CN113425384A (zh) * 2021-05-19 2021-09-24 北京华腾创新科技有限公司 一种多功能穿刺装置
CN113509221A (zh) * 2021-07-05 2021-10-19 江西医为特科技有限公司 一种带有自动液压监控功能的内窥镜手术系统

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