CN112891654A - 直接吸附鞘管 - Google Patents

直接吸附鞘管 Download PDF

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CN112891654A
CN112891654A CN202110278436.7A CN202110278436A CN112891654A CN 112891654 A CN112891654 A CN 112891654A CN 202110278436 A CN202110278436 A CN 202110278436A CN 112891654 A CN112891654 A CN 112891654A
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刘焕杰
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Shenzhen Furui Optoelectronic Technology Co ltd
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Abstract

一种与内窥镜部件组合使用的直接吸附鞘管，用于内窥镜激光微创手术，通过引入吸附窗口直接吸附病灶、将手术光纤的发射窗口靠近吸附窗口的设计，实现激光或切除或消融或粉碎，同步清理手术碎片，内窥镜摄像头能够观察激光对病灶作用的功能。

Description

直接吸附鞘管
技术领域
直接吸附鞘管是一种与内窥镜单元组合的带有吸引功能的鞘管，用于微创激光手术。
背景技术
激光是一种可以通过光纤传输的能量源，在微创手术中特别是利用人体的狭窄器官通道将激光能量送达病灶处并进行切除或者消融如肿瘤，粉碎如结石，汽化如韧带等。这种切除、消融、粉碎和汽化往往是人体病灶中水分子对激光的吸收而发生的汽化、消融和微爆破的结果。
内窥镜广泛地应用于当今微创手术并具有多种结构形式，为了方便扩展内窥镜的临床应用，内窥镜应采用组合单元结构，具有摄像头、照明光和传输视频信号和照明信号的鞘管的标准单元，内外鞘管等。
美国专利US7104983B2，MichaelGrassso于2006年提出了带吸附功能的钬激光碎石装置,就日益普及的钬激光微创手术特别是泌尿系结石手术，申请号为2019105356725《吸引激光鞘》的发明专利，刘焕杰提出了直接吸附且具有较高激光手术效率的光纤发射窗口与吸附通道的吸附窗口的结构组合，实现了术中吸附住病灶或结石，激光高效祛除病灶组织或结石，同时清除手术碎片，以大幅提升手术效率，也对一些感染结石治疗时导致的医源性术中感染并发症具有积极的作用。该解决方案能够很好地配合内窥镜和钬激光设备等实施微创手术特别是泌尿系结石手术。
与通过单独的吸引激光鞘器械和内窥镜器械组合实施微创手术，手术器械因自身的尺寸限制，加上内窥镜因为要满足众多手术器械的需要，通常其部件如器械通道设计具有一定范围尺寸的内径，以适应不同尺寸的手术器械的兼容性。这样独立设计的器械的疗效和适应症都受到一定的限制，特别是目前微创手术技术追求的是更微创的临床技术如超细经皮肾镜（mini-PCNL）钬激光碎石，输尿管软镜（FURS）软镜碎石等，对内窥镜和器械要求更小的尺寸，更好的性能操控性等，因此通过设计具有直接吸附激光手术内窥镜在临床应用上更具有优势。
于波与2014年在专利201420393842.3《经皮肾压力自动平衡循环水灌注吸引清石装置》对内窥镜的鞘管进行改进并引入灌注压力平衡的概念。硕通镜针对碎石用内窥镜在保留了标准内窥镜单元的设计前提下，对内窥镜的传统外镜鞘进行了改进，在灌注通道里增加了负压吸引功能，这样负压吸引水流，水流夹带结石粉末提升碎石手术清石性能。
本专利公布了一种改进的直接吸附鞘管，通过与标准内窥镜单元进行组合形成直接吸附激光手术内窥镜，使得内窥镜能够直接吸附病灶，同时实现高效激光病灶切割如肿瘤切除、病灶粉碎如结石粉碎、病灶消融如韧带汽化，同步清理手术病灶弃物，也就是切除、碎石、消融与清除同步。同时该直接吸附激光手术内窥镜还保留了传统激光手术内窥镜的其它相关功能如器械通道，灌注等功能。
发明内容
直接吸附鞘管，由至少吸附通道和连接件单元所构成，吸附通道开有吸附窗口，在直接吸附鞘管与内窥镜单元组合后，吸附窗口能够直接吸附病灶同时手术光纤发射窗口能够靠近吸附窗口，手术光纤发射窗口输出的激光作用在病灶时能够被标准内窥镜的摄像头所观察到。
与直接吸附鞘管组合的内窥镜单元至少包括摄像头，照明光源，内窥镜鞘管。
吸附通道的吸附窗口为或吸附通道的部分前端和部分侧端的组合开口，或前端开口，或侧端开口。
直接吸附鞘管通过连接件单元与内窥镜单元进行组合成为直接吸附激光手术内窥镜，组合后内窥镜单元的先端相对吸附窗口的位置相对固定。
直接吸附鞘管与内窥镜单元组合后成为直接吸附激光手术内窥镜的先端和吸附窗口的相对位置通过操作连接件可以改变。
直接吸附鞘管的结构根据待组合的内窥镜单元的不同结构，或直接包含有手术光纤通道，这时内窥镜单元只包括摄像头与照明光与鞘管，或不包括手术光纤通道，而光纤通道则包含在内窥镜单元中，组合后而成的直接吸附激光手术内窥镜在手术光纤安装时和后，手术光纤可以在光纤通道中前后移动。
直接吸附鞘管的直接吸附通道的尾端设有接口并通过该接口连接负压源或负压源的管线。
直接吸附通鞘管设有吸附开关，实现组合后激光手术内窥镜接通和关断所连接的负压源。
直接吸附鞘管在与内窥镜单元组合后的直接吸附激光手术内窥镜后，吸附通道或只作为吸引用途，或者即可用于吸引用途，又可兼做其它手术器械通道。
附图说明
图1为直接吸附鞘管一种实施例的侧向示意图。
图2为实施例的侧向剖面示意图
图3为实施例的A向与B向横截面示意图。
图4为包含摄像头与照明光的内窥镜单元图。
图5为组合后的直接吸附手术内窥镜侧向示意图。
图6为组合后的直接吸附手术内窥镜头端局部示意图。
图7为直接吸附鞘管一种实施例的侧向示意图。
图8为实施例的A向与B向横截面示意图。
图9为包含摄像头、照明光、光纤和灌注通道的内窥镜单元。
图10为组合后的直接吸附手术内窥镜侧向示意图。
图11为直接接吸附鞘管与内窥镜单元组合后的A向与B向横截面示意图。
图12为组合后的吸附窗口与内窥镜先端的相对位置示意图。
图13为定位件示意图。
具体实施方式
图1为一种直接吸附鞘管的侧向示意图，由吸附鞘管30-1和连接件单元34所构成。如图2所示，其中吸附鞘管30-1包含中空的吸附通道10，中空光纤通道23并在鞘管30-1的头端开口21，灌注通道并设有灌注入口43，吸附鞘管30-1的头端出口41，中空通道30’，中空通道30’用来安装引导内窥镜单元，其尾端处在连接件单元34上设有内窥镜单元固定连接件34-1，用来固定安装的内窥镜单元，头端开口31’，吸附鞘管30-1满足人体生物兼容的的相关要求。
吸附通道10的前端（手术端）开有吸附窗口11，在负压源接通后吸附窗口能够直接吸附病灶组织。吸附窗口11有多种开口方式，或部分前端面和侧面的组合开口，或前端面部分或者全部开口，或完全在吸附通道侧面开口（参见发明专利CN2019105356725《吸引激光鞘》），尾端设有吸附通道接口15，用于外接负压源的连接管线，吸附通道10安装有吸附开关13，用来手术前后和当中切断和连通吸附窗口11与外接负压源的负压，该吸附开关13安装在连接件34上，开关种类可以有不同选择如自锁，不带自锁等，方便医生操作（开关可以采用行业内标准件）。
连接件单元34有连接件34-1，用于与内窥镜组合后的锁定与松解，该连接件34-1的结构设计与组合的内窥镜的连接口34’相匹配，在内窥镜单元的位置安装到位后，通过旋转改变34-1的位置可以将直接吸附鞘管与内窥镜单元锁住或者解开。
直接吸附鞘管前端A向的横截面示意图和尾端B向横截面示意图分别为图3中的左图和右图所示。
内窥镜单元如图4所示，鞘管30，视频信号接口，光源接口和连接口34’等构成。鞘管30其先端31由摄像头31-1和照明光窗口31-2所构成，鞘管30是摄像头视频信号的传输通道和照明光传输通道的集合。39为照明光源接入口，35为摄像头视频信号输出口，用于连接视频接收单元。将内窥镜单元的先端31和鞘管30插入直接吸附鞘管的中空导管30’直到34-1与34’相互到位，旋转连接件34-1将内窥镜单元与直接吸附鞘管锁定，与此同时，内窥镜单元先端31突出到开口31’外。
直接吸附鞘管与图4所示的内窥镜单元组合后的直接吸附激光手术内窥镜如图5所示，手术光纤通过光纤通道23入口29接入，通过光纤输送按钮26可以往内窥镜先端方向输送光纤，使得光纤发射窗口20-1能够移动到吸附窗口11的附近，如图6所示，从光纤发射窗口20-1发射出的激光作用被吸附窗口11吸附的病灶组织时，能够被内窥镜单元的摄像头31-1观察到。
与图9所示的内窥镜单元组合的直接吸附鞘管实施例如图7所示，直接吸附鞘管由吸附导管10，连接件单元34以及连接件34-1所构成，吸附导管10即是吸附通道，头端开有吸附窗口11，尾端设有负压源接口15。图8左图是直接吸附鞘管A向时的横截面示意图，右图是B向时的横截面示意图。图9的内窥镜单元包含内窥镜鞘管30，内窥镜先端31，内窥镜鞘管30内安装有摄像头视频信号传输通道和照明光的传输通道，照明光连接照明光源的接口39，视频传输通道的延伸33和目镜35同时也是视频信号与视频信号接收单元的接口。内窥镜单元还安装了手术器械通道，该手术器械通道设有器械入口29，手术光纤和其它类型的器械从此口插入器械通道和退出器械通道。该器械通道还设有对称的灌注口43，每个灌注口设有灌注开关。内窥镜的尾端22即有与内窥镜单元为一体的结构，也有可以与内窥镜单元分开的结构。内窥镜单元连接件34’是内窥镜行业的标准设计，广泛采用，实施例为旋转式连接件结构，也可采用按压弹簧式结构和拨动弹簧式结构等多种设计，如前所述，连接件34-1与34’必须匹配。
松开直接吸附鞘管的连接件34-1，通过连接件单元34的通道30’插入内窥镜单元鞘管30，内窥镜单元插入到位后，旋转连接件34-1将直接吸附鞘管与内窥镜单元组合成为直接吸附激光手术内窥镜。组合后的直接吸附激光手术内窥镜如图10所示，其中内窥镜单元的尾端22为拆分结构并被拆卸，安装了光纤输送单元24，该单元24安装有光纤输送按钮26，手术光纤入口29，手术光纤的位置改变操作与《吸引激光鞘》相同，不在此描述。对于不可拆卸的内窥镜尾端22设计，可以外接手术光纤与入口29的紧固件，用于保持手术光纤发射窗口在手动调整后在内窥镜的位置不变。
组合后的直接吸附激光手术内窥镜的A向与B向横截面示意图如图11所示，直接吸附鞘管的结构设计使得组装后直接吸附激光手术内窥镜的光纤通道的端口21应该紧贴吸附通道10的外沿，使得手术光纤安装后其发射窗口20-1能够紧贴吸附窗口11。灌注入口的水流通过43流入内窥镜，经器械通道口41流入手术处，再经吸附窗口11被抽吸到人体之外。
组合后的直接吸附激光手术内窥镜的内窥镜器械通道即是手术光纤通道，通过光纤通道入口29插入手术光纤，通过光纤输送按钮26可以将光纤发射窗口输送到吸附窗口11附近。如图12所示，组合后的直接吸附激光手术内窥镜的内窥镜先端31相对吸附窗口11的位置可以改变，图中X1，X2和X3代表先端31在图10中的连接件34-1锁定后可以固定的位置，图10中位置定位件34-2，为了配合位置X1，X2和X3共有2个尺寸的定位件，定位件34-2的结构示意图如图13所示，实现与连接件34-1及内窥镜的连接件34’的对接，其轴是一个圆形导管用于通过内窥镜鞘管30。
为了方便组合后的直接吸附激光手术内窥镜的插入人体和组合后的直接吸附鞘管与内窥镜单元的稳定性，图7中的实施例也可采用图1中的实施例的直接吸附鞘管30-1类似的结构，即鞘管30-1包裹着吸附通道10和待插入的内窥镜鞘管30’,这种结构类似内窥行业广泛采用的外鞘管技术。
本说明书所描述的直接吸附鞘管实施例只是为了说明怎样构成本发明，但不限于说明书所描述的结构方式。

Claims (9)

1.直接吸附鞘管，至少由开有吸附窗口的吸附通道，连接件单元所构成，其特征在于直接吸附鞘管与内窥镜单元组合后，吸附窗口能够直接吸附病灶同时手术光纤发射窗口能够靠近吸附窗口，手术光纤发射窗口输出的激光作用在病灶时能够被内窥镜单元的摄像头所观察到。
2.按照权利要求1所述的直接吸附鞘管，其特征在于组合的内窥镜单元至少包括摄像头，照明光源，内窥镜鞘管。
3.按照权利要求1所述的直接吸附鞘管，其特征在于吸附通道的吸附窗口为或吸附通道的部分前端和部分侧端的组合开口，或前端开口，或侧端开口。
4.按照权利要求1所述的直接吸附鞘管，其特征在于直接吸附鞘管通过连接件与内窥镜单元进行组合成为直接吸附手术内窥镜，且位置相对固定。
5.按照权利要求1所述的直接吸附鞘管，其特征在于与内窥镜单元组合后成为的直接吸附激光手术内窥镜单元的先端和吸附窗口的相对位置可以改变。
6.按照权利要求1所述的直接吸附鞘管，其特征在于与手术光纤通道或在直接吸附鞘管内，或在待组合的内窥镜鞘管内，安装手术光纤后手术光纤可以在光纤通道中前后移动。
7.按照权利要求1所述的直接吸附鞘管，其特征在于直接吸附通道的尾端设有接口并通过该接口连接负压源的管线。
8.按照权利要求1所述的直接吸附鞘管，其特征在于直接吸附通鞘管有吸附开关，实现组合后激光手术内窥镜接通和关断所连接的负压源。
9.按照权利要求1所述的直接吸附鞘管，其特征在于吸附通道在组合后的直接吸附激光手术内窥镜或只作为吸附通道，或者兼顾吸附通道与器械通道。
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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN114209425A (zh) * 2022-01-07 2022-03-22 武汉大学 一种激光治疗癌细胞和肿瘤的装置及治疗方法

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN114209425A (zh) * 2022-01-07 2022-03-22 武汉大学 一种激光治疗癌细胞和肿瘤的装置及治疗方法
CN114209425B (zh) * 2022-01-07 2023-12-22 武汉大学 一种激光治疗癌细胞和肿瘤的装置及治疗方法

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