CN113040904A - Adsorption laser operation endoscope - Google Patents

Abstract

The laser-absorption surgical endoscope can absorb a target focus when performing endoscopic surgery, achieves synchronization of laser excision or ablation of the focus and removal of generated focus fragments or surgical wastes, and has higher efficiency of laser surgical cutting or laser working, so that the efficiency of minimally invasive surgery is greatly improved.

Description

Adsorption laser operation endoscope

Technical Field

An absorption laser operation endoscope is a medical operation endoscope which can absorb focus, implement high-efficiency or excision or ablation or pulverization of the focus by laser and synchronously clean operation fragments.

Background

Laser is an energy source which can be transmitted through optical fibers, and in a minimally invasive surgery, particularly, a narrow organ channel of a human body is utilized to deliver laser energy to a focus to perform excision or ablation, such as tumor, crushing, such as calculus, and vaporizing, such as ligament. Such ablation, pulverization and vaporization are often the result of vaporization, ablation and micro-blasting of water molecules in the lesion of the body by absorption of laser light.

Modern medical endoscopes provide visual field illumination and operation visual field images for clinical minimally invasive surgery, provide channels for energy sources such as lasers and surgical instruments such as forceps and scissors to reach focuses, and remove operation focus wastes out of a human body by pouring water flow, air flow and the channels thereof for the purposes of achieving clear operation visual field and cooling operation sites of the focuses. Endoscopes are often classified in the manner of application to human organs or clinical departments such as transforaminal, arthroscopes, cholangioscopes, cystoscopes, uretero-nephroscopes, hysteroscopes. The endoscopes for diagnosis and treatment in the same organ or department are named according to the characteristics of the endoscopes, and are used for distinguishing ureteral nephroscope (hard) and ureteral soft scope, hard cystoscope and fibrous cystoscope.

Soft lens such as ureter soft lens is a laser operation endoscope improved aiming at the soft characteristic of laser treatment optical fiber, is mainly used for treating urinary calculus, and has been widely developed and applied worldwide in recent 5 years. Such soft mirrors have room for improvement in the synergy of the fiber of the laser energy source and the negative pressure source.

The endoscope not only affects the operation efficiency and increases the operation time, but also causes serious iatrogenic complications due to the fact that laser irradiates a focus or cuts or ablates or crushes the focus, surgical fragments are diffused or jumps and the like in the operation process.

The wolf brand is an innovative endoscope used for cutting hysteromyoma and automatically adsorbing the cut hysteromyoma fragments to be far away from an operation focus to the outside of a body, and the adsorption function is introduced into the electrotomy endoscope.

In wave and 2014, the sheath tube of the endoscope for implementing laser lithotripsy is improved and the concept of perfusion pressure balance is introduced in the utility model 201420393842.3 'percutaneous renal pressure automatic balance circulating water perfusion suction lithotripsy device'. Aiming at the endoscope for laser lithotripsy, the conventional outer endoscope sheath of the endoscope is improved on the premise of keeping the design of the endoscope unit, and negative pressure suction and stone collection performance are increased for water flow (stone powder is carried in the water flow). However, a disadvantage of both of these improved laser lithotripsy endoscopes is that stones and crushed stone fragments are not directly attracted to the outside of the body by negative pressure, but rather are washed out of the body by the absorption of a water stream which entrains the stone fragments. The calculus is not fixed during crushing, and the calculus is jumped under the influence of washing water flow and laser pulse.

The U.S. Pat. No. 7104983B2, michael grassso, in 2006 proposed a holmium laser lithotripsy device with an adsorption function, and with regard to the increasingly popular holmium laser minimally invasive surgery, in particular to urinary calculus surgery, the invention patent with application number 2019105356725 "attracting laser sheath" proposed by banger that a structure combination of an optical fiber emission window directly adsorbing a lesion and having higher laser surgery efficiency and an adsorption window of an adsorption channel is provided, so that the lesion or calculus is adsorbed in the surgery, the lesion tissue or calculus is efficiently removed by laser, and surgical fragments are removed at the same time, so that the surgery efficiency is greatly improved, and the holmium laser lithotripsy device also has a positive effect on iatrogenic intraoperative infection complications caused by treatment of infectious calculus. The solution can be well matched with an endoscope, holmium laser equipment and the like to implement minimally invasive surgery, in particular urinary calculus surgery.

In combination with minimally invasive surgery performed by a single suction laser sheath instrument and an endoscopic instrument, the surgical instruments are limited in size by themselves, and because endoscopes are designed to meet the needs of many surgical instruments, components such as instrument channels are typically designed with a range of sized inner diameters to accommodate the compatibility of different sized surgical instruments. The curative effect and the indication of the surgical instrument are limited to a certain extent, particularly, the current minimally invasive surgical technology pursues more minimally invasive clinical technologies such as superfine percutaneous nephroscope (mini-PCNL) holmium laser lithotripterygium, ureter soft scope (FURS) soft scope lithotripterygium and the like, the endoscope and the instrument are required to be smaller in size and better in performance controllability, and therefore the endoscope has the advantage of direct adsorption laser surgery in clinical application through design.

The laser surgical absorption endoscope introduces a negative pressure suction function into the endoscope for implementing laser minimally invasive surgery, and performs reasonable structural design on the mirror absorption channel and the optical fiber channel after the negative pressure is introduced in a targeted manner, so that efficient laser focus cutting such as tumor resection, focus smashing such as calculus smashing, focus ablation such as ligament vaporization, and synchronous cleaning of surgical focus wastes, namely synchronous resection, calculus smashing, ablation and removal, are realized, the surgical efficiency is greatly improved, the threshold of surgical instruments is reduced, and the laser surgical absorption endoscope has positive significance for treating infectious focuses. Meanwhile, the adsorption laser surgical endoscope also retains other related functions of the traditional laser surgical endoscope, such as instrument channel, perfusion and the like.

Disclosure of Invention

An absorption laser operation endoscope is technically characterized in that an absorption channel directly absorbs operation focuses such as tumors, stones, soft tissues and ligaments, an optical fiber emission window is moved to the position near the absorption window of the absorption channel, so that the absorbed focuses can be removed by laser of the optical fiber emission window efficiently, namely, the absorbed focuses are cut off or ablated or smashed, and meanwhile removed operation fragments are absorbed and cleaned out of a human body. The laser emitted from the fiber emission window can be observed by a camera of the endoscope when the laser is applied to the focus. The adsorption of the adsorption window to the focus is realized by the way that the conveying of the optical fiber emission window can change the position in the operation optical fiber channel by advancing and retreating under the action of a negative pressure source connected outside the endoscope. Different with present endoscope, this absorption of absorption laser operation endoscope and operation fibre channel have the structural feature of combination for the emission window of operation optic fibre is when moving absorption window annex, because emission window and absorption window are very close to, makes operation optic fibre emission window can press close to the focus tissue, obtains higher laser focus tissue effect efficiency, and the direct absorption of absorption window to the focus can also keep simultaneously, can also be observed by the endoscope camera.

The operation optical fiber can move back and forth in the adsorption laser operation endoscope, so that the optical fiber emission window can be always close to an operation focus, and meanwhile, the adsorption window is not hindered to be worth directly adsorbing.

The optical fiber channel and the adsorption channel of the direct adsorption laser endoscope operation have various combination modes, and according to the requirement of the overall design of the endoscope, the various combination modes comprise the operation optical fiber channel or the external tangent plane design and the occupying adsorption channel space design outside the adsorption channel, or in the adsorption channel, the inner wall which is close to the adsorption channel often has better adsorption and laser action effects. The interior and exterior of the adsorption channel are defined by the physical boundaries of the adsorption channel.

The sheath tube material of the laser surgery endoscope is rigid, the endoscope is a rigid endoscope, the material is soft or rigid but adopts a bendable structural design, and the endoscope is a soft endoscope.

After the adsorption laser operation endoscope is provided with the operation optical fiber, the optical fiber emission window can move back and forth in the operation optical fiber channel before, after and in the laser operation, the movement is realized by an operation doctor, an optical fiber button of the endoscope can be directly operated, even the operation optical fiber is directly moved back and forth by hands, the movement can also be realized by a control keyboard or a control program of an operation robot, and the adsorption laser operation endoscope or a part of the operation robot is adsorbed at the time.

The adsorption window structure of the adsorption laser surgical endoscope is arranged at the front end of the adsorption channel, can be completely arranged on the side surface of the front end of the adsorption channel, and can also be a combined opening of partial front end and side surface.

The tail end of the adsorption channel of the adsorption laser surgical endoscope is provided with an interface externally connected with a negative pressure source, and the interface is connected with the negative pressure source or a pipeline of the negative pressure source.

The absorption laser operation endoscope is provided with an absorption switch of an absorption channel, and the absorption switch enables the absorbed focus tissues to be reset at the position of the absorption window by switching off and switching on a negative pressure source outside the endoscope, and the laser effect of the absorption laser operation endoscope and the laser effect of the optical fiber emission window are changed accordingly. Or the external negative pressure source is switched on and off before, during and after the operation, so that the attraction of the negative pressure source is disconnected with the focus. The switch can be executed manually or by a program control scheme, and the laser surgical endoscope is usually a component of a surgical robot or a navigator by adsorption in a program control mode.

According to different application or design requirements of the adsorption laser surgical endoscope, the adsorption channel is only a special adsorption channel or has the functions of the adsorption channel and a surgical instrument channel.

The pick-up lens or the electronic device of the laser surgery endoscope generates an electric signal or the optical component generates an optical signal.

The illumination light absorbed by the laser operation endoscope comes from an illumination light source and is transmitted in the endoscope through an optical fiber, an optical fiber bundle or a light guide rod medium to reach the front end of the endoscope to illuminate the focus and the operation field, or a light emitting source directly arranged on an illumination window.

The absorption laser operation endoscope is provided with a perfusion interface for externally connecting water flow or air flow, and the interface can be provided with a control switch for controlling the water flow or the air flow to be switched on or off according to the operation requirement.

The absorption laser surgical endoscope is measured structurally, or is of an integral structure, or is of a split structure formed by combining and disassembling a plurality of components, which is called a combined structure for short. Even can be with the absorption laser operation endoscope that standard endoscope unit on the market combines with combination absorption sheath pipe, connecting piece unit, focus tissue is directly adsorbed by the absorption window under the effect of negative pressure and is lived, operation optic fibre advances and retreats thereby realizes changing the position of operation optic fibre emission window in the fibre channel, when operation optic fibre emission window is close to the absorption window of absorption channel, can be observed by the camera of this endoscope when the laser that launches from the optic fibre emission window high-efficiently acts on the focus, do not hinder the absorption window to the direct absorption of focus simultaneously.

The position of the adsorption window of the combined adsorption laser surgical endoscope relative to the endoscope unit front end lens can be changed.

Drawings

FIG. 1 is a side schematic view of one embodiment of a suction laser surgical endoscope.

FIG. 2 is a schematic view of the embodiment of FIG. 1 showing the distal end A of the endoscope after the optical fiber is installed in place.

FIG. 3 is a partial cross-sectional view of the distal end of the endoscope of FIG. 1 after installation of the surgical optical fibers.

FIG. 4 is a schematic structural view of different combinations of the suction channel at the tip of the endoscope and the fiber emission window.

FIG. 5 is a schematic view of the adsorption channel boundary.

FIG. 6 is a lateral view of the fiber button and the mechanism for delivering surgical optical fibers.

Fig. 7 is a schematic view of an endoscope unit.

Fig. 8A is a schematic side view of the left combined type adsorption sheath and connector unit of fig. 7.

Fig. 8B is a schematic side view of the combined adsorbing sheath and connector unit shown in fig. 7.

Fig. 9 is a longitudinal cross-sectional view of the combined adsorptive sheath and connector unit of fig. 8B.

Fig. 10A is a schematic view of the combined adsorbing sheath and connector unit of fig. 8A in a direction (left) and a direction (right).

Fig. 10B is a schematic view of the combined adsorbing sheath and connector unit of fig. 8B in a direction a (left) and a direction B (right).

Fig. 11A is a side view of the assembled suction laser surgical endoscope.

Fig. 11B is a side view of the assembled suction laser surgical endoscope.

Fig. 12A is a schematic view showing that the position of the suction window relative to the distal end of the endoscope unit is variable.

Fig. 12B is a schematic view of a positioning member.

Detailed Description

As shown in fig. 1, an embodiment of an absorption laser surgical endoscope is shown, wherein an absorption channel 10 is provided with an opening at a front end (i.e. a surgical lesion end) thereof, i.e. an absorption window 11, the absorption channel 10 is provided with a negative pressure source interface 15 at an operation end (i.e. a tail end of the endoscope or the tail end of the absorption channel 10) of the endoscope, the absorption window 11 of the absorption channel can be connected to a negative pressure source through the interface 15, and the connection and disconnection of the negative pressure source are realized through an absorption switch 13. The surgical fiber channel 23 has an opening 21 at the distal end of the endoscope, and the surgical fiber 20 is inserted into the endoscope through the fiber entrance 29 before operation and mounted to its fiber emission window 21 to the vicinity of the suction window 11. The video signal cable and the illumination light source transmission cable of the endoscope share the same sheath 30. The endoscope of the present embodiment employs an electronic camera element, and therefore, an image electric signal is transmitted inside the sheath 30, and the device-side cable 32 of the sheath 30 is branched into an electric signal cable and connected to the image signal receiving unit through the interface 35. The other is furcated into a fiber optic cable and connected to the illumination source by an optical plug 39. And 43 is a fill inlet. In the embodiment, the sheath 30, the suction channel 10, and the optical fiber channel 20 may be collectively referred to as a sheath of an endoscope, and more specifically, the sheath may be a sheath of an image signal and illumination light, a sheath of a suction channel, a sheath of a surgical optical fiber channel, or the like.

Fig. 2 shows a schematic view of the distal end of an absorption laser surgical endoscope viewed from the distal end of the endoscope in a top view, i.e., an a-direction view, after the surgical optical fiber is attached to the absorption laser surgical endoscope and the optical fiber emission window 20-1 reaches the attachment position of the absorption window 11. The camera 31-1, which is a camera formed by a CCD electronic component in this embodiment, generates an electrical signal as a video signal. The technology realized by the invention is not limited to the specific category of the camera, but a matched video signal transmission mode is adopted. For example, a camera using an optical element transmits an optical video signal to an optical video signal receiving unit, and generally, a transmission medium of the optical video signal is an optical fiber, an optical fiber rod, or an optical lens group. The illuminating light window 31-2 can inject the light of the illuminating light source to the surgical focus through the optical fiber or the optical fiber bundle or the optical fiber rod and the optical plug 39, or directly is a micro-luminous source. The present invention is not limited to a specific illumination light technology, and the illumination light schemes used in the current endoscopes are all acceptable, but must be matched illumination light transmission schemes.

As shown in FIG. 2, the surgical fiber emission window 20-1 is located between the camera 31-1 and the absorption window 11, and the arrangement facilitates the camera 31-1 to observe the interaction between the laser and the tissue from the emission window 20-1, thereby ensuring the surgical field and the surgical safety. To obtain a better surgical view, the camera may use different angular viewing directions, such as 7 °, 12 °, 30 °, etc., depending mainly on the sheath structure and size. As shown in fig. 3, the distal end portion of the endoscope is designed such that the camera, the illumination light and the fluid outlet 41 are arranged in a plane, and the suction window 11 is located at a certain distance from the plane of the distal end where the camera is located in the longitudinal direction of the endoscope, wherein the distance is generally 3-10mm, but not limited to the above range, according to the conventional technical criteria of the camera in the current endoscope industry, such as depth of field, focal length, etc. The fluid passes through the perfusion inlet 41 and reaches the endoscope tip outlet 41 through the internal channel of the endoscope sheath tube to enter the surgical lesion (the perfusion channel is the basic structure of the endoscope, and the description of the perfusion channel is omitted here), and then flows out of the human body and the endoscope through the adsorption window 11, the adsorption channel 10 and the negative pressure source interface 15.

As shown in fig. 3, the opening of the adsorption window 11 is the top + side combination of the adsorption channel 10. There are other structural options for the adsorption window 11. As shown in fig. 4, right, the adsorption window 11 is either at the front end of the adsorption passage 10 or at the side. The combination of the adsorption channel 10 and the surgical optical fiber channel 23 is not limited to the embodiment of fig. 2, i.e. the tangential manner of the optical fiber channel 23 clinging to the outer wall of the adsorption channel 10, as shown in fig. 4, the top end of the tube wall of the adsorption channel 10 protrudes to form a space to form the combination of the optical fiber channel 23. The combination structure of the adsorption window 11 and the surgical optical fiber emission window 20-1 can also be formed by clinging the optical fiber channel 23 to the inner wall of the adsorption channel 10. As shown in fig. 5, the line 10-1 (protruding in thickness) is the physical boundary of the adsorption channel, and the left figure shows the fiber channel 23 either outside the adsorption channel 10 and circumscribed to the boundary 10-1 of the adsorption channel 10 or inside the adsorption channel 10 and inscribed to the physical boundary 10-1 of the adsorption channel. The right-side optical fiber channel 23 is outside the adsorption channel 10, which is formed by partially recessing the physical boundary 10-1, and usually, in the combination manner of the adsorption channel and the optical fiber channel of the right-side drawing, the opening of the adsorption window 11 includes a part of the side portion of the adsorption channel 10, so as to obtain the best direct adsorption of the adsorption window 11 to the lesion, and facilitate the observation of the camera 31-1 to the optical fiber emission window.

The suction channel 10 of the suction laser operation endoscope is provided with a suction switch 13, the suction switch 13 is used for switching on and off negative pressure, the type of the switch is selected according to different use habits of doctors, the switch is provided with a self-locking function or is not provided with a self-locking function, the structure of the switch belongs to an example in a textbook, and the structure of the switch is not described in the specification. The suction switch 13 may also be an automatically controllable switch element such as an electromagnetic valve, which is usually controlled by a program to open and close, and in this case, the suction laser surgical endoscope may be a robot arm portion of a surgical robot or a navigation device or a component thereof, and the suction channel is switched on and off by operating a control keyboard.

The direct adsorption of the adsorption window 11 to the lesion means that the lesion tissues are adsorbed by the adsorption window 11 and contact each other under the attraction of the negative pressure source even if the optical fiber emission window 20-1 is near the adsorption window 11. The focal tissue can be faded away due to the action of the laser, so that the action efficiency of the optical fiber emission window on the focal is reduced, at the moment, the negative pressure suction source can be disconnected, or the position of the adsorption window 11 is changed to switch on the negative pressure again, or only the negative pressure is switched on again, so that the focal is reset at the position of the adsorption window 11, and the action efficiency of the laser on the focal is restored again. Or partially cutting off with laser, and switching on and off the negative pressure according to the requirement.

The combination principle of the adsorption window 11 and the installed operation optical fiber emission window 20-1 is that the two should be as close as possible to ensure the efficient effect of laser on the lesion tissues adsorbed on the adsorption window 11, but the emission window 20-1 cannot prevent the adsorption window 11 from directly adsorbing or directly adsorbing the lesion, and meanwhile, the optical fiber emission window 20-1 can be observed by the camera 31-1. In various combinations of the present invention, the relative positions of the suction channel 10 and the fiber channel 23 are fixed, and may be varied as illustrated in FIG. 11 for another embodiment below.

In order to reduce the overall size of the endoscope, the outer diameter of the suction channel should be as small as possible, and therefore the inner diameter of the suction channel 10 should be selected as small as possible, and the minimum inner diameter should be selected with reference to the size of the fragments of the laser-pulverized stone as a design reference. The laser lithotripsy has different selectable working modes, and the size of the pulverized lithotripsy stone fragments is smaller and is the main basis for designing the size of the minimum inner diameter. For other types of surgery, such as tumor resection, the outer diameter of the suction channel need not be small, depending on the size of the surgical debris and the requirements of the surgical channel. In order to achieve the effect of negative pressure suction, the whole suction channel is normally closed except for the window 11 and the negative pressure source interface 15, even if the suction switch 13 is installed. In order to prevent extreme situations, normally open small holes can be opened on the wall of the adsorption channel 10 near the adsorption window 11 for negative pressure relief.

To meet the requirements for assembling the optical fiber, the inner diameter of the fiber passage 23 is larger than the outer diameter of the optical fiber 20. In order to reduce the overall cross-sectional size of the endoscope, the size of the fiber channel 23 should be as small as possible. Currently 365 core fiber can transmit hundreds of watts of holmium laser power, and the outer diameter of the fiber is about 550um, so the typical inner diameter of the fiber channel is 600um, and the outer diameter is 0.7-0.8 mm. Of course, smaller outer and inner diameters of the channel can be selected, for example, a 272um core fiber with an outer diameter of 450mm can be used in a ureteroscope. If the embodiment of the left drawing in FIG. 4 is used, the convex suction channel wall may also be the outer wall of the fiber channel. The surgical fiber channel 23 is not necessarily a hollow channel requiring full-range continuity, and may even be a hollow channel without a middle section, but it is ensured that the surgical fiber 20 does not hinder the movement and installation of the fiber when penetrating through the fiber channel 23. For the disposable absorption laser operation endoscope, the inner wall of the optical fiber channel 23 can be even coated with a thin layer of clear water coating, so that the friction when the optical fiber 20 is inserted is reduced.

The embodiment of fig. 6 illustrates a schematic diagram of the optical fiber button 26 and its optical fiber feeding mechanism, but is not limited to the schematic diagram. After the surgical fiber 20 is threaded through the fiber delivery structure along the axis of the fiber entrance 29 and channel 23, the fiber launch window 20-1 can be moved forward by continuously depressing and releasing the gun trigger fiber button 26. The embodiment shown in fig. 6 employs a mechanical pencil-like structure, where the fiber optic button 26 is a gun-like trigger 26. When the button or trigger 26 is pushed to the bottom, the optical fiber delivery structure lock cylinder 26-3 is blocked by the stopper 26-4, the optical fiber 20 which is held and moved by a specific step length is released, after the trigger 26 is released, the link 26-1 returns to the original position under the action of the spring body 26-2, and the optical fiber lock cylinder 26-3 holds the optical fiber 20 again. The optical fiber 20 is manually moved toward the distal end of the endoscope, which is characterized in that the optical fiber emission window 20-1 advances one step distance each time the trigger 26 is pulled. The hold-down trigger 26 is released and fiber 20 is retracted by manually grasping fiber 20 to move fiber 20 back. The movement of the optical fiber in the endoscope can also be driven by a micro motor and is controlled to advance and retreat through program control, generally, the laser-absorbing surgical endoscope can be a robot arm part or a component part of a surgical robot or navigation equipment, and the back and forth movement of the optical fiber is realized through the operation of a control keyboard.

If the compatibility of the endoscope with other surgical instruments such as a surgical forceps, scissors, a biopsy forceps and the like is considered, the suction channel 10 can also be used as an instrument channel, and for the endoscope with the design, the suction channel 10, the suction window 14 and the negative pressure source interface 15 need to be designed into a structural design on the same axis, so that the surgical instruments can pass through the channel conveniently. When the surgical instrument is connected, the negative pressure source interface 15 is used as an insertion port of the surgical instrument instead of being connected with a negative pressure source pipeline.

The sheath structure of the endoscope of the various embodiments can be made of hard materials, and the constructed laser-absorbing surgical endoscope is a hard tube endoscope. If flexible materials or hard tube materials of snake bone structures are adopted, the formed laser absorption surgical endoscope is a soft lens. The structure of the soft lens is the basic structure in the industry, and is not described in detail herein, and reference can also be made to the Chinese patent application 'A directional bending endoscope catheter' (2020110871235). The design and manufacture of the endoscope flexible endoscope sheath tube when bending the optical fiber channel 20 include that the material must meet the requirement of being incapable of deflection and deformation, and the tube wall of the optical fiber channel 23 is preferably continuous, so that the insertion and installation of the surgical optical fiber 20 in the optical fiber channel 23 are convenient. Of course, there are exceptions to the continuity of the tube wall of the optical fiber channel 23, and when the soft lens of the laser-absorbing surgical endoscope is in a straight state or has a small curvature, the optical fiber can be installed in place first, and the curvature of the mirror is increased during surgery.

Fig. 7 shows an embodiment of a combined suction laser surgery endoscope in which an endoscope unit of a conventional endoscope product on the market is combined with a combined suction sheath 30-1 (or suction sheath 10) and a connector unit. As shown in fig. 7, the endoscope unit includes an endoscope sheath 30, an endoscope distal end 31, a camera video signal transmission channel and an illumination light transmission channel are installed in the endoscope sheath 30, the illumination light is connected to an interface 39 of an illumination light source, and an extension 33 of the video transmission channel and an eyepiece 35 are also interfaces with a video signal receiving unit. The endoscope unit also houses a surgical instrument channel, also referred to as the fiber channel 23, which is provided with an instrument access port 29 through which surgical fibers and other types of instruments are inserted into and withdrawn from the instrument channel. The instrument channel is also provided with symmetrical perfusion ports 43, each of which is provided with a perfusion switch. The tail end 22 of the endoscope is configured to be integrated with the endoscope unit or to be separable from the endoscope unit. As shown in fig. 7, the right endoscope unit includes a sheath 30, and the distal end 31 is constituted by a camera and an illumination light window, and the sheath 30 is a set of a transmission channel of a camera video signal and an illumination light transmission channel. 39 is an illumination light source inlet, 35 is a camera video signal outlet, and is used for connecting a video signal receiving unit and a connecting port 34'.

The endoscope unit connecting port 34 'is a standard design in the endoscope industry and is widely adopted, the embodiment is a rotary connecting piece structure, and various designs such as a pressing spring type structure and a toggle spring type structure can also be adopted, and the connecting port 34' must be matched with a connecting piece 34-1 of a connecting piece unit on a suction sheath tube below.

Fig. 8 is a side view of 2 embodiments of a combined type suction sheath and connector unit, both of which include a suction channel 10, a suction window 11 formed at the head end of the suction channel, a negative pressure source interface 15 and a suction switch 13 formed at the tail end of the suction channel, a connector unit 34 and a connector 34-1. The embodiment illustrated in fig. 8A and B differs in that the direct adsorption sheath 30-1 of fig. 8B further includes a fiber channel and a perfusion channel, a fiber button 26 and a fiber inlet 29, while the direct adsorption sheath 30-1 of fig. 8A is directly the adsorption channel 10.

Taking the endoscope unit shown on the left side of fig. 7 and the direct-suction sheath and connector unit shown in fig. 8A as examples, the direct-suction sheath is composed of a suction catheter 10, a connector unit 34 and a connector 34-1, the suction catheter 10 is a suction channel, the head end is provided with a suction window 11, and the tail end is provided with a negative pressure source interface 15. The connecting piece 34-1 for directly adsorbing the sheath is loosened, the endoscope unit sheath 30 is inserted through the channel 30' (fig. 10) of the connecting piece unit 34, and after the endoscope unit is inserted to the position, the connecting piece 34-1 is rotated to combine the directly adsorbing sheath and the endoscope unit into an adsorbing laser operation endoscope. The assembled suction laser surgical endoscope is shown in fig. 11, in which the tail end 22 of the endoscope unit is a detachable structure and is detached, an optical fiber delivery unit 24 is installed, the optical fiber delivery button 26 is installed on the unit 24, and a surgical optical fiber inlet 29 is formed, and the position change operation of the surgical optical fiber can be realized through the optical fiber button 26. For a non-detachable endoscope tail end 22 design, fasteners may be attached externally to the surgical fiber and access port 29 for maintaining the surgical fiber firing window in place on the endoscope after manual adjustment.

The endoscope instrument channel of the combined absorption laser surgical endoscope is a surgical optical fiber channel, a surgical optical fiber is inserted through the optical fiber inlet 29, and the optical fiber emission window can be conveyed to the vicinity of the absorption window 11 through the optical fiber conveying button 26. As shown in fig. 12, the position of the endoscope tip 31 of the assembled laser surgery endoscope relative to the suction window 11 can be changed, wherein X1, X2 and X3 represent the positions where the tip 31 can be fixed after being locked by the connecting piece 34-1 in fig. 11A, the position locating piece 34-2 in fig. 11, and the structure schematic diagram of the locating piece 34-2 is shown in fig. 12B, so as to match the locating pieces with 2 sizes in the positions X1, X2 and X3, and realize the butt joint with the connecting piece 34-1 and the connecting piece 34' of the endoscope, and the shaft of the positioning piece is a circular pipeline and is used for passing through the sheath tube of the endoscope.

To facilitate insertion of the combined suction laser surgery endoscope into the body and stability of the combined direct suction sheath and endoscope unit, the embodiment of fig. 11A may also employ a structure similar to the direct suction sheath 30-1 of the embodiment of fig. 11B, i.e., the sheath 30-1 encloses the suction channel 10 and the endoscope sheath 30' to be inserted, which is similar to the outer sheath technique widely employed in the endoscope industry.

The endoscope unit shown on the right of fig. 7 and the direct suction sheath and connector unit embodiment shown in fig. 8B are installed substantially the same as above, and the direct suction sheath of the invention patent is omitted or referred to herein.

Claims (14)

1. The absorption laser operation endoscope comprises a camera, an illumination light source, an endoscope sheath tube, an operation optical fiber channel and an absorption channel, and is characterized in that the laser operation endoscope can directly absorb a focus and the operation optical fiber emission window can be close to the absorption window, and laser output by the operation optical fiber emission window can be observed by the camera of the endoscope when the focus is on.

2. The absorption laser surgical endoscope according to claim 1, wherein the movement of the emission window of the surgical fiber is performed in the surgical fiber channel.

3. The suction laser surgical endoscope according to claim 1, wherein the surgical optical fiber is either outside the suction channel or inside the suction channel after being mounted to the endoscope.

4. An absorption laser surgical endoscope according to claim 1, characterized in that the endoscope sheath material is either rigid, the endoscope is rigid, the material is either flexible or rigid but of a bendable construction design, and the endoscope is a flexible endoscope.

5. The absorption laser surgical endoscope according to claim 1, wherein the movement of the emission window of the surgical optical fiber is controlled either manually or by a program.

6. The absorption laser surgical endoscope according to claim 1, wherein the absorption channel is provided with an absorption window, and the absorption window is a combined opening of a part of the front end and a part of the side end of the absorption channel, or a front end opening, or a side end opening.

7. The suction laser surgical endoscope according to claim 1, characterized in that the suction channel is provided with an interface and is connected to a negative pressure source or a negative pressure source line through the interface.

8. The suction laser surgical endoscope according to claim 1, characterized in that the suction channel is provided with a suction switch for switching the surgical endoscope on and off a connected negative pressure source.

9. The suction laser surgical endoscope according to claim 1, characterized in that the suction channel functions either as suction channel only or as both suction channel and instrument channel.

10. The absorption laser surgical endoscope according to claim 1, wherein the camera is either an electronic device or an optical element.

11. The absorption laser surgical endoscope according to claim 1, wherein the illumination light source is either an illumination fiber, an illumination fiber bundle, or a light guide rod for transmitting illumination light, or a light emitting source directly mounted on the illumination window.

12. The absorption laser surgical endoscope according to claim 1, wherein the absorption laser surgical endoscope is equipped with a perfusion access port for accessing water flow or air flow, and the access port is provided with a control switch for controlling the on and off of the external water flow or air flow.

13. The suction laser surgical endoscope according to claim 1, wherein the suction endoscope is either a unitary structure or a separable structure that can be assembled.

14. The suction laser surgical endoscope according to claim 13, wherein the combinable suction windows are positionally changeable with respect to the distal end of the endoscope unit.

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