CN113598946B

CN113598946B - Take visual puncture of super microchannel of negative pressure suction's percutaneous kidney and expand integrative external member

Info

Publication number: CN113598946B
Application number: CN202111003631.5A
Authority: CN
Inventors: 胡嘉盛
Original assignee: Ningbo First Hospital
Current assignee: Ningbo First Hospital
Priority date: 2021-08-30
Filing date: 2021-08-30
Publication date: 2022-07-15
Anticipated expiration: 2041-08-30
Also published as: CN113598946A

Abstract

The invention provides a percutaneous renal ultramicro-channel visible puncture and expansion integrated kit with negative pressure suction, which comprises: the sheath tube is provided with an inner opening end part at the distal end of the sheath tube and an outer opening end part at the proximal end of the sheath tube, a negative pressure channel and a perfusion channel which are mutually independent are arranged in the sheath tube, and the negative pressure channel and the perfusion channel are separated by a separation wall; the expansion pipe joint is connected with the outer opening end part of the near end of the sheath pipe, and a catheter device is arranged on the expansion pipe joint and can be used for infusing washing water into the infusion channel or operating instruments; and the negative pressure output device is connected with the end part of the outer opening of the proximal end of the sheath tube and is communicated with the negative pressure channel in a sealing way. By improving the sheath tube structure, the sheath tube structure meets the functional requirements of liquid injection and stone suction, ensures wide visual field and clear image, can suck and discharge larger stone fragments, avoids repeated work, reduces the time consumption for operation, improves the operation efficiency and reduces the working intensity of doctors.

Description

Take visual puncture of super microchannel of negative pressure suction's percutaneous kidney and expand integrative external member

Technical Field

The invention relates to the technical field of medical auxiliary instruments, in particular to a percutaneous renal ultramicro-channel visible puncture and expansion integrated kit with negative pressure suction.

Background

Renal calculus is one of the most common diseases in urinary surgery, and percutaneous nephroscope surgery is a minimally invasive technique widely used for treating renal calculus at present, and the technique is a surgical method for lithotripsy and stone extraction operation under the direct vision of an endoscope by establishing a micro-channel from skin to a kidney collecting system.

In the past 20 years, scholars at home and abroad make continuous efforts to realize minimally invasive percutaneous nephrolithotomy, and design a series of minimally invasive PCNL, including minimally invasive percutaneous nephrolithotomy (mini-m all innovative PCNL), chinese-style MPCNL (chinese MPCNL), ultra-fine percutaneous nephrolithotomy (UMP-PCNL), Micro-channel percutaneous nephrolithotomy (Micro-PCNL), and the like. In practice, people gradually realize that the problems of insufficient perfusion, unclear vision, slow stone removal speed, high renal pelvis internal pressure and the like exist in the process of simply narrowing the channel. super-mini-PCNL (SMP) with a perfusion negative pressure suction system can better solve the problems of insufficient perfusion, blurred vision, high renal pelvis internal pressure and the like, however, SMP is only suitable for treating renal calculus with the diameter less than 2.5 cm.

In addition, when the traditional percutaneous nephroscope operation enters the kidney due to puncture in clinic, an operator judges the puncture position by depending on hand feeling or predicting the depth under the guidance of ultrasound, CT and the like, and the methods are relatively blind and time-consuming, and have the problems of easy generation of complications such as bleeding, residual stones, sepsis and the like due to errors.

Disclosure of Invention

In view of this, the invention aims to provide a percutaneous renal ultramicro-channel visible puncture and expansion integrated kit with negative pressure suction, which meets the functional requirements of liquid injection and stone suction by improving the sheath structure, ensures wide visual field and clear image, can suck and discharge larger stone fragments, avoids repeated work, reduces the time consumption for operation, improves the operation efficiency and reduces the working intensity of doctors.

In order to achieve the purpose, the technical scheme of the invention is realized as follows:

a visual puncture of super microchannel of percutaneous kidney that takes negative pressure suction expands integrative external member, includes:

a sheath having an inner open end at a distal end of the sheath for introduction into a body region requiring a surgical procedure and an outer open end at a proximal end of the sheath, the sheath having a mutually independent negative pressure channel and an irrigation channel therein, the negative pressure channel being separated from the irrigation channel by a separation wall;

the expansion pipe joint is connected with the outer opening end part of the near end of the sheath pipe, and a catheter device is arranged on the expansion pipe joint and can be used for perfusing flushing water and/or operating instruments into the perfusion channel;

and the negative pressure output device is connected with the end part of the outer opening of the proximal end of the sheath tube and is communicated with the negative pressure channel in a sealing way.

Further, the sheath includes:

the distal end of the outer sheath is provided with a puncture tip, and the outer sheath is an expandable sheath;

the inner sheath tube is sleeved in the outer sheath tube, the inner sheath tube is tightly attached to the outer sheath tube, and the inner sheath tube can rotate and/or move relative to the outer sheath tube;

the negative pressure channel and the perfusion channel are arranged inside the inner sheath tube, the perfusion channel forms a first connecting part at the near end of the inner sheath tube, and the first connecting part is connected with the expansion tube joint in a sealing way; the negative pressure channel is arranged at the near end of the inner sheath pipe to form a second connecting part, and the second connecting part is connected with the negative pressure output device in a sealing mode.

Further, the inner sheath includes:

the inner sheath tube wall is arranged in a circular tube shape and is an expandable sheath tube wall;

the two ends of the partition wall are connected with the inner wall of the inner sheath tube wall, and the partition wall is arranged in an arc shape or a spline curve shape;

the working port is arranged at the far end of the inner sheath tube wall, the projection of the contour line of the working port is in an inclined straight line or arc line arrangement, the working port comprises a suction port and an irrigation port, the suction port is communicated with the negative pressure channel, the irrigation port is communicated with the irrigation channel, and the irrigation port is arranged on one side, close to the near end of the inner sheath tube wall, of the working port;

the value range of the ratio of the cross-sectional area of the negative pressure channel separated in the inner sheath tube wall to the cross-sectional area of the perfusion channel by the partition wall in the initial state is 2-8.

Further, the visual puncture and expansion integrated kit with the negative pressure suction percutaneous renal ultramicro channel further comprises:

the connection cover is arranged at the far end of the inner sheath tube wall and covers the suction port, a suction liquid port is arranged on the connection cover, and the suction liquid port and a liquid suction channel of the suction port are arranged in an included angle mode.

Further, the first connection portion includes:

the first connecting boss is arranged on the outer side of the proximal end part of the inner sheath tube wall;

and the first external thread is arranged outside the first connecting boss and is used for being in thread sealing with the first internal thread on the expansion pipe joint.

Further, the second connection portion includes:

the first connecting pipe part is integrally formed with the near end of the negative pressure channel in the inner sheath pipe;

a variable diameter part for converting the first connection pipe into a circular connection pipe;

a second connecting pipe portion provided on a side of the variable diameter portion away from the first connecting pipe portion;

the tube cavity penetrates through the second connecting tube part, the reducing part and the first connecting tube part and is communicated with the negative pressure channel;

the second external thread is arranged on the outer surface of the end part, far away from the diameter-variable part, of the second connecting pipe part and is used for being in threaded sealing connection with the head plate;

the second internal thread is arranged on the inner surface, far away from the end opening of the variable-diameter part, of the second connecting pipe part and is used for being in threaded sealing connection with the negative pressure output device.

Further, the expansion joint comprises:

the first annular connecting part is used for being connected with the first connecting part in a sealing way;

an arcuate enlargement on which the catheter device is disposed;

the second annular connecting part is arranged at one end of the arc-shaped enlarged part, which is far away from the first annular connecting part, and the second connecting part extends out of the proximal end part of the second annular connecting part;

the head sealing plate is connected with the second connecting part in a sealing mode, and the outer edge of the head sealing plate is connected with the second annular connecting part port in a sealing mode;

the cross-sectional area of the arc-shaped enlarged portion is gradually increased from one side close to the first annular connecting portion to one side close to the second annular connecting portion.

Further, the percutaneous kidney ultramicro-channel visible puncture and expansion integrated kit with negative pressure suction further comprises:

the pull wire ring is arranged on the inner wall of the inner sheath pipe wall close to the position of the far-end outlet and is connected with the inner sheath pipe into a whole;

the far end of the pull wire is fixedly connected with the pull wire ring, and the near end of the pull wire is fixedly connected with the adjusting piece;

the adjusting piece is arranged on the expansion pipe joint and can drive the stay wire to move to one side so as to bend the far end of the inner sheath pipe to one side;

wherein, the regulating part includes:

the winding ring is sleeved on the fixed shaft and can be pushed or pulled relative to the fixed shaft, the winding ring can rotate relative to the fixed shaft bearing in a pushing state, the winding ring is fixed relative to the fixed shaft in a pulling state, and the fixed shaft is fixed on the outer surface of the pipe wall of the connecting part;

the winding groove is arranged in an annular groove and can accommodate a wound stay wire;

and the adjusting handle is fixedly connected with the winding ring and is used for rotating the winding ring.

Further, the head plate includes:

a plate body for covering an end opening of the second annular connecting portion;

the connecting table is arranged on one side of the plate body and used for sealing an opening between the outside of the second connecting pipe part and the inside of the second annular connecting part;

the connecting hole penetrates through the plate body and the connecting table and is communicated with the negative pressure channel;

the third internal thread is arranged inside the connecting hole and is in threaded connection with the second external thread on the second connecting part;

and the sealing rib is arranged on the outer surface of the connecting table.

Further, the negative pressure output device includes:

the negative pressure connecting pipe comprises a third connecting end, a third connecting external thread is arranged on the outer surface of the third connecting end, and the third connecting external thread is in threaded connection with a second internal thread on the second connecting part;

the negative pressure suction pipe is communicated with the negative pressure channel and can generate negative pressure suction at the suction port under the action of a negative pressure source;

and the finger covering groove is arranged on the negative pressure draft tube, and a negative pressure adjusting hole is arranged in the finger covering groove.

Compared with the prior art, the percutaneous renal ultramicro channel visible puncture and expansion integrated kit with negative pressure suction has the following advantages:

(1) according to the percutaneous kidney ultramicro-channel visible puncture and expansion integrated kit with negative pressure suction, the sheath tube structure is improved, the sheath tube comprising the mutually independent negative pressure channel and the perfusion channel is arranged, the working port at the far end of the sheath tube is arranged to be an inclined structure, and the inclined structure is provided with the connecting cover with the suction liquid port arranged in an included angle with the working port, so that the suction efficiency is ensured, the stone taking operation of large stone fragments can be completed, the damage to a patient is reduced, and the risk of secondary operation caused by residual stones is avoided.

(2) The percutaneous renal ultramicro-channel visual puncture and expansion integrated kit with negative pressure suction can meet the puncture and expansion requirements, can also perform operations such as bending, rotating, moving and the like on an inner sheath tube, and realizes the purpose of accurately treating a treated part,

drawings

The accompanying drawings, which are included to provide a further understanding of the invention, illustrate embodiments of the invention and together with the description serve to explain the invention and do not constitute a limitation of the invention. In the drawings:

FIG. 1 is a schematic side view of a microchannel visible puncturing and expanding integrated set according to an embodiment of the present invention;

FIG. 2 is a schematic cross-sectional structural view of a visible puncture and dilation integrated kit of an ultramicrochannel according to an embodiment of the present invention;

FIG. 3 is a partial enlarged view of the portion A in FIG. 2;

FIG. 4 is a schematic structural diagram of a sheath of the integrated assembly for visualization puncture and dilation of a super-micro channel according to an embodiment of the present invention;

FIG. 5 is a schematic cross-sectional view of the inner sheath according to the embodiment of the present invention;

FIG. 6 is a schematic view of the distal end of the inner sheath according to the embodiment of the present invention;

FIG. 7 is a schematic structural diagram of a connecting cover according to an embodiment of the present invention;

FIG. 8 is a schematic view of the structure of the distal end of the inner sheath tube connected to a pull wire according to the embodiment of the present invention;

fig. 9 is a schematic structural view of the pull wire ring according to the embodiment of the present invention;

FIG. 10 is a schematic view of the proximal end of the inner sheath according to the embodiment of the present invention;

fig. 11 is a schematic side view of a proximal end of the inner sheath from a first perspective according to an embodiment of the present invention;

fig. 12 is a schematic side view of a proximal end of the inner sheath from a second perspective according to an embodiment of the present invention;

FIG. 13 is a schematic structural view of the expansion joint in accordance with the embodiment of the present invention;

FIG. 14 is a schematic top view of an embodiment of the expansion joint of the present invention;

FIG. 15 is a front elevational view of the expansion joint in accordance with the embodiment of the present invention;

FIG. 16 is an enlarged partial view of the portion B in FIG. 15;

FIG. 17 is a schematic side view of the head plate according to the embodiment of the present invention;

fig. 18 is a schematic front view of the head plate according to the embodiment of the invention;

FIG. 19 is a schematic side view of a negative pressure output device according to an embodiment of the present invention;

FIG. 20 is a schematic structural view of a second expansion joint in accordance with an embodiment of the present invention;

FIG. 21 is a schematic cross-sectional view of a second inner sheath according to the embodiment of the present invention;

description of the reference numerals:

a sheath tube 1, a sheath tube distal end 101, a sheath tube proximal end 102, an outer sheath tube 2, an inner sheath tube 3, an inner sheath tube wall 301, a partition wall 302, a working port 304, a suction port 304a, a flushing port 304b, a strain relief sleeve 4, a first limit boss 401, a relief sleeve wall 402, an expansion tube joint 5, a first annular connecting portion 501, a connecting portion tube wall 5011, a fixed shaft 5012, a first internal thread 5013, an arc-shaped enlarged portion 502, a second annular connecting portion 503, a catheter device 504, a first catheter 5041, a second catheter 5042, a third catheter 5043, an adjusting member 505, a winding ring 5051, a winding groove 5052, an adjusting handle 5053, an adjusting rib 50531, an adjusting ring 50532, a grip groove 50533, a negative pressure output device 6, a negative pressure suction tube 601, a source 602, a negative pressure connecting tube 603, a third connecting external thread 604, a second limit boss 606, a finger covering groove 607, a negative pressure adjusting hole 608, a negative pressure channel 7, the infusion channel 8, the connecting cover 9, the annular bottom plate 901, the circular top plate 902, the connecting rib 903, the suction liquid port 904, the first connecting portion 10, the first connecting boss 1001, the first external thread 1002, the second connecting portion 11, the tube cavity 1101, the first connecting portion 1102, the reducing portion 1103, the second connecting tube portion 1104, the second external thread 1105, the second internal thread 1106, the pull wire ring 12, the ring body 1201, the ring groove 1202, the first wiring groove 1203, the pull wire 13, the sealing plate 14, the plate body 1401, the connecting hole 1402, the third internal thread 1403, the operating boss 1404, the connecting table 1405, the sealing rib 1406, the sealing gasket 1407 and the guide wire cavity 15.

Detailed Description

In order to make the technical means, objectives and functions of the present invention easy to understand, embodiments of the present invention will be described in detail with reference to the specific drawings.

It should be noted that all terms used in the present invention for directional and positional indication, such as: the terms "upper", "lower", "left", "right", "front", "rear", "vertical", "horizontal", "inner", "outer", "top", "lower", "transverse", "longitudinal", "center", and the like are used only for explaining the relative positional relationship, the connection, and the like between the respective members in a certain state (as shown in the drawings), and are only for convenience of describing the present invention, and do not require that the present invention must be constructed and operated in a certain orientation, and thus, should not be construed as limiting the present invention. In addition, the descriptions related to "first", "second", etc. in the present invention are for descriptive purposes only and are not to be construed as indicating or implying relative importance or implicitly indicating the number of technical features indicated.

In the description of the present invention, unless otherwise explicitly specified or limited, the terms "mounted," "connected," and "connected" are to be construed broadly and may, for example, be fixedly connected, detachably connected, or integrally connected; may be a mechanical connection; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meanings of the above terms in the present invention can be understood in a specific case to those of ordinary skill in the art.

In the description herein, references to the description of the term "one embodiment," "some embodiments," "an illustrative embodiment," "an example," "a specific example," or "some examples" or the like mean that a particular feature, structure, material, or characteristic described in connection with the embodiment or example is included in at least one embodiment or example of the invention. In this specification, the schematic representations of the terms used above do not necessarily refer to the same embodiment or example. Furthermore, the particular features, structures, materials, or characteristics described may be combined in any suitable manner in any one or more embodiments or examples.

Example 1

As shown in figures 1-5, the invention discloses a percutaneous renal ultramicro-channel visible puncture and expansion integrated kit with negative pressure suction, which comprises:

a sheath 1, said sheath 1 having an inner open end of a sheath distal end 101 for introduction into a body region requiring a surgical operation, and an outer open end of a sheath proximal end 102, a negative pressure channel 7 and a perfusion channel 8 being provided independently of each other within said sheath 1, said negative pressure channel 7 being separated from said perfusion channel 8 by said partition wall 302;

an expansion tube joint 5 connected to the outer open end of the sheath proximal end 102, the expansion tube joint 5 being provided with a catheter device 504, the catheter device 504 being capable of irrigating the irrigation channel 8 with irrigation water and/or a manipulator;

and the negative pressure output device 6 is connected with the outer opening end part of the sheath tube near end 102, and the negative pressure output device 6 is communicated with the negative pressure channel 7 in a sealing way.

The invention relates to a visible puncture and expansion integrated kit with a negative pressure suction percutaneous renal ultramicro channel, which is characterized in that a sheath 1 comprising a negative pressure channel 7 and an infusion channel 8 which are independent from each other is arranged, the tube wall of the sheath 1 is a generally circular tube, the inner opening end part of the distal end 101 of the sheath is used for being introduced into a body area needing to be subjected to a surgical operation, when in use, flushing water is infused into the infusion channel 8 through a conduit device 504 on an expansion tube joint 5, the flushing water can remove stone fragments or kidney stones from tissues, the negative pressure channel 7 is used for sucking the stone fragments and secretions out of the body through a negative pressure output device 6 to the outer opening end part of the proximal end 102 of the sheath so as to be discharged out of the body, the sheath can complete suction, suction and/or movement and/or rotation under the action of a control device, and a partition wall 302 is arranged between the negative pressure channel 7 and the infusion channel 8, the partition wall 302 can be flexibly deformed when in use, so that the sheath tube 1 can properly adjust the cross sections of the negative pressure channel 7 and the perfusion channel 8 according to the needs, the flow of perfusion water is ensured, and the kidney stone can still be discharged out of the body through the negative pressure channel 7 under the condition of slightly large kidney stone.

As a preferred example of the present invention, the sheath 1 includes:

the distal end of the outer sheath tube 2 is provided with a puncture tip, and the outer sheath tube 2 is an expandable sheath tube;

the inner sheath tube 3 is sleeved inside the outer sheath tube 2, the inner sheath tube 3 is tightly attached to the outer sheath tube 2, and the inner sheath tube 3 can rotate and/or move relative to the outer sheath tube 2;

the negative pressure channel 7 and the perfusion channel 8 are arranged inside the inner sheath 3, the perfusion channel 8 forms a first connecting part 10 at the proximal end of the inner sheath 3, and the first connecting part 10 is connected with the expansion pipe joint 5 in a sealing way; the negative pressure channel 7 forms a second connecting part 11 at the proximal end of the inner sheath tube 3, and the second connecting part 11 is connected with the negative pressure output device 6 in a sealing manner.

The arrangement discloses a sheath tube structure, a first connecting part 10 and a second connecting part 11 are respectively formed at the near end of an inner sheath tube 3 through a negative pressure channel 7 and a perfusion channel 8 which are arranged in the inner sheath tube 3, wherein the second connecting part 11 is arranged at one side of the first connecting part 10 close to the near end, the second connecting part 11 is arranged in the first connecting part 10, the first connecting part 10 and the second connecting part 11 are hard sheath tube sections, an expansion tube joint 5 connected with the first connecting part 10 and a negative pressure output device 6 connected with the second connecting part 11 are both arranged outside the body, the rotation or stretching movement of the inner sheath tube 3 is realized through operating the expansion tube joint 5, so that the inner sheath tube 3 can rotate relative to the outer sheath tube 2, or the far end of the inner sheath tube 3 can extend into or slide out of the far end of the outer sheath tube 2, the tip arranged at the far end of the outer sheath tube 2 is used for puncturing the sheath tube when in use, and the puncturing process can be monitored in real time through optical fibers or visual devices such as an endoscope and the like, so that the sheath tube can be accurately inserted in place, and the sheath tube can be prevented from being inserted too deeply or not in place.

The sheath 1 structure of the invention can meet the puncture and expansion requirements, and can also perform bending, rotating, moving and other operations on the inner sheath, thereby realizing the purpose of accurately treating the treatment part.

As a preferred example of the present invention, the inner sheath 3 includes:

an inner sheath wall 301, which is arranged in a circular tube shape and is an expandable sheath wall;

the two ends of the partition wall 302 are connected with the inner wall of the inner sheath tube wall 301, and the partition wall 302 is arranged in an arc shape or a spline curve shape;

a working port 304 disposed at the distal end of the inner sheath tube wall 301, wherein the projection of the contour line of the working port 304 is disposed in an inclined straight line or arc line, the working port 304 includes a suction port 304a and an irrigation port 304b, the suction port 304a is communicated with the negative pressure channel 7, the irrigation port 304b is communicated with the irrigation channel 8, and the irrigation port 304b is disposed on the side of the working port 304 near the proximal end of the inner sheath tube wall 301;

the value range of the ratio of the cross-sectional area of the negative pressure channel 7 and the cross-sectional area of the perfusion channel 8, which are separated in the inner sheath tube wall 301, to the cross-sectional area of the partition wall 302 in the initial state is 2-8.

The arrangement is improved through the port structure at the far end of the inner sheath tube 3, the working port 304 arranged in an inclined shape is formed, the flushing port 304b is arranged at the near end side inclined on the working port 304, namely the suction port 304a is arranged at the far end side inclined on the working port 304, so that the cleaning liquid filled in the filling channel 8 is mixed with stone fragments to form water flow vortex under the action of the flushing port 304b, the cleaning liquid in the collecting system can quickly mix the stone fragments to form a high-pressure area locally, and further, under the action of the suction port 304a, the negative pressure channel 7 and the negative pressure output device 6, the stone fragments are quickly flushed and discharged along with the vortex effect formed by high-pressure water flow and the double action of negative pressure, the reasonable limitation of the negative pressure channel 7 and the filling channel 8 is realized through the arranged partition wall 302, and the stone fragment cleaning and pumping efficiency is greatly improved, and can pump larger stone fragments (e.g., 3mm to 3.5mm in diameter) to remove stones.

The arrangement ensures the cleaning and suction effects of the percutaneous renal ultramicro-channel visible puncture and expansion integrated kit with negative pressure suction in use, can be suitable for removing large stone fragments, and is safe and reliable to use.

As a preferred example of the present invention, the hardness of the partition wall 302 is less than that of the inner sheath tube wall 301, and the hardness of the distal end of the inner sheath tube wall 301 is less than that of the proximal end of the inner sheath tube wall 301. As an example of the present invention, the value of the Shore D hardness of the separation wall 302 ranges from 20 to 25; the shore hardness D of the far end of the inner sheath tube wall 301 ranges from 32 to 37; the shore D hardness of the proximal end of the inner sheath tube wall 301 is 65-70, the shore D hardness of the tube wall between the distal end of the inner sheath tube wall 301 and the proximal end of the inner sheath tube wall 301 is 40-60, wherein the hardness can be changed by material selection and/or the thickness of one or more layers (for example, the outer layer) of the catheter, the tip of the outer sheath tube 2 is made of a hard metal material, the outer sheath tube wall on the proximal side of the tip is an expandable sheath tube wall, the shore D hardness of the inner sheath tube wall 301 is smaller than the shore D hardness of the expandable sheath tube wall of the outer sheath tube 2, and the separation wall 302, the inner sheath tube wall 301 and the outer sheath tube wall are all made of any one of medical polyurethane materials.

As a preferred example of the present invention, as shown in fig. 6, the percutaneous renal super-microchannel visible puncture dilation integrated kit with negative pressure suction further comprises:

the connection cover 9 is arranged at the distal end of the inner sheath tube wall 301 and covers the suction port 304a, a suction liquid port 904 is arranged on the connection cover 9, and the suction liquid port 904 and a liquid suction channel of the suction port 304a are arranged in an included angle.

This arrangement is improved by optimizing the configuration of the suction port 304a, which is less efficient if a planar suction port 904 is used, and which tends to cause jamming of the suction port 304a when larger stone fragments are suctioned. The liquid suction port 904 is arranged to form an included angle with the liquid suction channel of the suction port 304a, so that the suction efficiency can be greatly improved, and the liquid suction port 904 with a larger size can be arranged according to the requirement, not only limited to the caliber of the suction port 304 a.

Specifically, as shown in fig. 7, the connection cover 9 includes:

an annular bottom plate 901 for fixed connection with the inner sheath tube wall 301 and the partition wall 302 at the suction port 304 a;

a circular ceiling plate 902 provided in the extending direction of the annular bottom plate 901 away from the suction port 304 a;

the connecting ribs 903 are arranged between the circular top plate 902 and the annular bottom plate 901;

and a liquid suction port 904 arranged between two adjacent connecting ribs 903.

As an example of the present invention, the connection rib 903 is provided in plural, and a projected area of the plural suction liquid ports 904 on the suction port 304a covers the entire suction port 304 a.

The arrangement further realizes the screening of stone fragments, ensures the suction efficiency, avoids the larger stone fragments from entering the inner sheath tube 3 to cause structural damage, and ensures the use safety of the percutaneous renal ultramicro-channel visible puncture and expansion integrated suite with negative pressure suction.

As a preferred example of the present invention, as shown in fig. 8, the integrated set with negative pressure suction percutaneous renal ultramicro-channel visual puncture and dilation further comprises:

the pull wire ring 12 is arranged on the inner wall of the inner sheath tube wall 301 close to the position of the distal end outlet and is connected with the inner sheath tube 3 into a whole;

a pull wire 13, the distal end of which is fixedly connected with the pull wire ring 12, and the proximal end of which is fixedly connected with the adjusting piece 505;

the adjusting piece 505 is arranged on the expansion pipe joint 5 and can drive the pull wire 13 to move to one side so as to bend the far end of the inner sheath pipe 3 to one side.

This setting makes 3 tip flexible uses of interior sheath pipe, under the visual device effect of cooperation, can be with the crooked or removal of the working port 304 of interior sheath pipe 3 to the position of target calculus fragment, and the calculus is just clear away thoroughly to the accuracy, reduces the damage to the patient, avoids the secondary operation risk that the incomplete stone brought.

Specifically, as shown in fig. 9, the pull wire ring 12 includes:

the ring body 1201 is embedded in the inner wall of the inner sheath tube wall 301;

the ring groove 1202 is annularly arranged on the inner wall of the ring body 1201, and the two pull wires 13 can be accommodated in the ring groove 1202;

a first wiring groove 1203, one end of which is connected with the ring groove 1202, and the other end of which extends to the end part of the ring body 1201 far away from the distal end 101 of the sheath, and is used for enabling the pull wire 13 to enter the ring groove 1202 and go out after encircling a circle;

wherein the first wiring trough 1203 is arranged within the perfusion channel 8.

Preferably, the gap between the pulling wire 13 and the ring groove 1202 and the gap between the first cabling groove 1203 are filled with glue, so that the inner surface of the inner sheath wall 301 is almost flush with the glue filled surface.

According to the arrangement, through the structure of the pull wire ring 12, the pull wire 13 is prevented from being damaged by stress concentration when the inner sheath tube 3 is pulled to be bent, the pull wire ring 12 is embedded in the inner wall of the inner sheath tube wall 301 of the pull wire, the pull wire 13 is fixed in the ring groove 1202 and the first wiring groove 1203 of the pull wire ring 12 through glue filling, the pull wire ring and the pull wire are fixed under the condition that extra size is not added, the thickness of the inner sheath tube wall 301 is not obviously influenced, and the safety and the reliability of the visual puncture and expansion integrated kit for the percutaneous renal ultramicro-channel with negative pressure suction are ensured.

As a preferred example of the present invention, as shown in fig. 10 to 16, the expansion joint 5 includes:

a first annular connecting portion 501 for being hermetically connected to the first connecting portion 10;

an arcuate enlargement 502, said catheter means 504 being disposed on said arcuate enlargement 502;

a second annular connecting portion 503, disposed at an end of the arc-shaped enlarged portion 502 away from the first annular connecting portion 501, and the second connecting portion 11 extends out of a proximal end of the second annular connecting portion 503;

the head plate 14 is connected with the second connecting part 11 in a sealing way, and the outer edge of the head plate 14 is connected with the port of the second annular connecting part 503 in a sealing way;

the cross-sectional area of the arc-shaped enlarged portion 502 is gradually increased from the side close to the first annular connecting portion 501 to the side close to the second annular connecting portion 503.

This arrangement discloses a specific structure of the expansion pipe joint 5, so that the duct device 504 can enter the filling passage 8 in a spiral shape when filling the cleaning liquid into the expansion pipe joint 5, further increasing the water flow swirl when the cleaning liquid flows out from the flushing port 304b, and ensuring the reliability of cleaning.

Preferably, as an example of the present invention, as shown in fig. 20 to 21, the catheter device 504 includes three catheters, namely a first catheter 5041, a second catheter 5042 and a third catheter 5043, wherein the first catheter 5041 is an infusion liquid catheter, the second catheter 5042 is a visualization device access tube, the third catheter 5043 is a guide wire access tube, and a guide wire lumen 15 is provided in the infusion channel 8 for accommodating placement of a guide wire.

As an example of the present invention, the first connection portion 10 includes:

a first connection boss 1001 provided on the outer side of the proximal end of the inner sheath tube wall 301;

and a first external thread 1002 provided outside the first connection boss 1001 for screw-sealing with a first internal thread 5013 on the first annular connection portion 501.

Preferably, a strain relief sleeve 4 is arranged on one side of the first connecting boss 1001, which is far away from the negative pressure output device 6, the strain relief sleeve 4 is sleeved on the proximal end of the inner sheath tube wall 301, the cross section of the strain relief sleeve 4 is gradually increased from one side, which is far away from the negative pressure output device 6, to one side, which is close to the negative pressure output device 6, a first limiting boss 401 is formed on the proximal end of the strain relief sleeve 4, the first limiting boss 401 can limit the depth of the first annular connecting portion 501 of the expansion tube joint 5 screwed into the first connecting portion 10, the strain relief sleeve 4 comprises a relief sleeve wall 402, and the pull wire 13 obliquely penetrates through the relief sleeve wall 402 and is fixed on the adjusting piece 505.

The arrangement ensures the stability and the tightness of the connection between the expansion pipe joint 5 and the first connecting part 10, and simultaneously, through the arranged strain relief sleeve 4, the near-end stress concentration caused by the visible puncture and expansion integrated sleeve with the negative pressure suction percutaneous renal ultramicro-channel kit when the far end is bent is avoided, and meanwhile, when the inner sheath pipe 3 is operated to rotate or move, the application force can be transmitted to the inner sheath pipe 3 from the expansion pipe joint 5 or the negative pressure output device 6, so that the reliable operation of bending, moving and rotating the inner sheath pipe 3 is facilitated.

Preferably, as an example of the present invention, as shown in fig. 3, 15, and 16, the adjusting member 505 according to the present invention includes:

the winding ring 5051 is sleeved on the fixed shaft 5012, the winding ring 5051 can be pushed or pulled relative to the fixed shaft 5012, in the pushing state, the winding ring 5051 can rotate relative to the fixed shaft 5012 in a bearing mode, in the pulling state, the winding ring 5051 is fixed relative to the fixed shaft 5012, and the fixed shaft 5012 is fixed on the outer surface of the connecting pipe wall 5011;

a winding slot 5052 which is provided in an annular shape and can accommodate the wound wire 13;

an adjusting handle 5053 is fixedly connected to the winding ring 5051 for rotating the winding ring 5051.

Specifically, the adjustment handle 5053 includes:

one end of the adjusting rib 50531 is fixedly connected with the winding ring 5051, and the other end extends outwards in an arc shape;

an adjustment ring 50532 disposed at a distal end of the adjustment rib 50531 remote from the winding ring 5051;

hand grip slots 50533 are formed between adjacent adjustment ribs 50531.

This setting discloses a concrete structure of regulating part 505, and the reasonable space that has utilized expansion pipe joint 5 and first connecting portion 10 junction, and the stay wire is adjusted convenient, reliable, the operation of being convenient for.

Preferably, as an example of the present invention, two adjusting members 505 may be provided, which are symmetrically arranged with respect to the central axis of the first annular connecting portion 501, and which respectively adjust two pulling wires 13, the two pulling wires 13 are connected to the same pulling wire ring 12, and both the two pulling wires 13 are provided in the perfusion channel 8. This setting makes the distal end of interior sheath pipe 3 can buckle to two directions under regulating part 505 effect, improves the degree of freedom that interior sheath pipe 3 distal end suction port 304a adjusted, and accurate, reliable completion gets stone work.

As a preferred example of the present invention, the second connection portion 11 includes:

a first connecting tube 1102 integrally formed with the proximal end of the negative pressure channel 7 in the inner sheath tube 3;

a diameter-variable portion 1103 for converting the first connection pipe 1102 into a circular connection pipe;

a second connecting pipe portion 1104 provided on a side of the reducing portion 1103 away from the first connecting pipe portion 1102;

a lumen 1101 that passes through the second connecting tube 1104, the reducing portion 1103, and the first connecting tube 1102 and communicates with the negative pressure passage 7;

a second external thread 1105 arranged on the outer surface of the end of the second connecting pipe portion 1104 far away from the reducing portion 1103 and used for being in threaded sealing connection with the head plate 14;

and a second internal thread 1106 is arranged on the inner surface of the end opening of the second connecting pipe portion 1104 far away from the variable-diameter portion 1103 and is used for being in threaded sealing connection with the negative pressure output device 6.

This setting discloses a concrete structure that forms second connecting portion on interior sheath pipe 3, because the cavity in interior sheath pipe 3 is cut apart into two heterotypic structures that have the arc wall by partition wall 302, and heterotypic structure general match nature is relatively poor when connecting, and connects the difficult assurance of leakproofness. This application is through carrying out the reducing with the near-end integrated into one piece's of negative pressure passageway 7 first connecting pipe portion 1102, becomes the pipe connection structure of a logical joining in marriage, very big improvement the convenience and the stability that second connecting portion 11 and negative pressure output device 6 and head board 14 are connected.

As a preferred example of the present invention, as shown in fig. 17 and 18, the head sealing plate 14 of the present invention includes:

a plate body 1401 for covering an end opening of the second annular connection portion 503;

a connection base 1405 disposed on one side of the plate body 1401 for covering an opening between the outside of the second connection pipe portion 1104 and the inside of the second annular connection portion 503;

a connection hole 1402 penetrating the plate body 1401 and the connection block 1405, the connection hole 1402 communicating with a negative pressure passage 7;

a third internal thread 1403 provided inside the connection hole 1402 and threadedly connected to the second external thread 1105 on the second connection portion 11;

a sealing rib 1406 provided on an outer surface of the connecting portion 1405.

This setting discloses the structure of an end sealing board 14, forms a spacing boss structure between plate 1401 and joint platform 1405 for carry on spacingly to the precession degree of depth of end sealing board 14, simultaneously, at the sealing rib 1406 of the surface setting of joint platform 1405, guaranteed the sealing connection of end sealing board and the contact department of second annular connecting portion 503.

Preferably, a packing 1407 is provided at a position where the plate body 1401 is connected to the connection base 1405. This arrangement further improves the sealing of the end open connection of the head plate 14 to the second annular joint 503.

Preferably, an operating boss 1404 is provided on a side of the plate body 1401 away from the connecting platform 1405, the operating boss 1404 is provided in an arc shape, two operating bosses 1404 are provided, and the two operating bosses 1404 are symmetrically arranged on the plate body 1401. This arrangement facilitates the mounting and dismounting of the head plate 14.

As a preferred example of the present invention, as shown in fig. 19, the negative pressure output device 6 according to the present invention includes:

the negative pressure connecting pipe 603 comprises a third connecting end 604, a third connecting external thread 605 is arranged on the outer surface of the third connecting end 604, and the third connecting external thread 605 is in threaded connection with a second internal thread 1106 on the second connecting part 11;

a negative pressure suction pipe 601 communicating with the negative pressure passage 7 and capable of generating a negative pressure suction force at the suction port 304a by a negative pressure source 602;

and a finger cover groove 607 provided in the negative pressure suction pipe 601, and a negative pressure adjustment hole 608 is provided in the finger cover groove 607.

The arrangement discloses a negative pressure output device 6, which is convenient for an operator to operate by fingers through a finger covering groove 607 arranged on a negative pressure suction pipe 601, so as to realize the plugging or the opening of a negative pressure adjusting hole 608, when the negative pressure adjusting hole 608 is not blocked, the negative pressure adjusting hole 608 can also be communicated with the surrounding atmosphere, so that any suction force generated by a negative pressure source does not provide obvious suction force at the far end of a negative pressure channel 7, the excessive pressure of the kidney can be effectively prevented, and meanwhile, when the suction force of the negative pressure channel 7 needs to be adjusted, the pressure adjustment during flushing or suction can also be realized by changing the covering area of the negative pressure adjusting hole 608.

Preferably, a second limit boss 606 is arranged on the negative pressure connecting pipe 603, and the second limit boss 606 is used for sealing and limiting after a third connecting external thread 605 on the negative pressure connecting pipe 603 is connected in place.

This arrangement further ensures the tightness of the connection of the negative pressure output device 6 to the second connection 11.

As an example of the invention, because the negative pressure channel 7 in the inner sheath 3 is connected with the negative pressure output device 6 through the second connecting part 11 formed at the proximal end of the inner sheath, if the sealing is not good, the negative pressure extraction work is abnormal, and the lithotomy cannot be normally performed, therefore, the applicant performs the sealing connection treatment at each connecting part, and the reliability of the negative pressure work and the negative pressure regulation is ensured.

When the endoscope is used, the inner sheath tube 3, the outer sheath tube 2, the strain relief sleeve 4, the expansion pipe joint 5 and the negative pressure output device 6 are combined together to form a percutaneous renal ultramicro channel visible puncture and expansion integrated kit with negative pressure suction, a puncture operation is carried out under the guidance of B-ultrasound or X-ray, the visible device enters the perfusion channel 8 through the second conduit 5042, due to the existence of the visible device, in the puncture process, the lens of the endoscope can be shielded by human organ tissues, bloody water or other dirt, the visual field is influenced, water can be injected through the first conduit 5041, the human tissue or the dirt is flushed away by the impact force of water flow to obtain a clear visual field, and when the integrated kit reaches the renal pelvis, the advance is stopped, so that the condition of over-puncture or renal puncture is not caused; the guide wire is extended into the guide wire cavity 15 of the perfusion channel 8 through the third conduit 5043 and finally extended out of the far end of the working port 304 on the inner sheath tube 3, so that the integral fixation of the integral kit is realized, when the calculus is sucked and taken, the bending, rotating and moving operations of the inner sheath tube 3 are performed through the control device according to the position of calculus fragments, the working port 304 of the inner sheath tube 3 is moved or swung to primarily search the calculus, the part of the inner sheath tube 3 extending out of the outer sheath tube 2 can be bent to accurately search the calculus in corners where some outer sheath tubes 2 cannot reach can be guided into the holmium laser from the perfusion channel 8 to perform the calculus crushing operation, meanwhile, water is injected through the first conduit 5041 to wash the visual device visual field, negative pressure is generated in the negative pressure channel 7 under the action of a negative pressure source through the negative pressure output device 6, and the calculus water and the fragments in the cavity are sucked out through the suction port 304a of the working port 304.

As an example of the present invention, the holmium laser may enter the inside of the cavity of the expanded pipe joint 5 through the third conduit 5043 to perform a stone crushing operation through the perfusion channel 8, or the holmium laser introduction may be performed through another conduit to perform a stone crushing operation.

The percutaneous kidney ultramicro-channel visible puncture and expansion integrated kit with negative pressure suction, provided by the invention, has the advantages that the functional requirements of liquid injection and stone suction are met by improving the sheath tube structure, the visual field is wide, the image is clear, large stone fragments can be sucked and discharged, the repeated work is avoided, the operation time is reduced, the operation efficiency is improved, and the working intensity of doctors is reduced.

The above description is only for the purpose of illustrating the preferred embodiments of the present invention and is not to be construed as limiting the invention, and any modifications, equivalents, improvements and the like that fall within the spirit and principle of the present invention are intended to be included therein.

Claims

1. The utility model provides a take visual puncture of super microchannel of negative pressure suction's percutaneous kidney and expand integrative external member which characterized in that includes:

a sheath (1), the sheath (1) having an inner open end at a distal sheath end (101) for introduction into a body region where a surgical operation is to be performed, and an outer open end at a proximal sheath end (102), a mutually independent negative pressure channel (7) and a perfusion channel (8) being provided in the sheath (1);

an expansion tube connector (5) connected with the outer opening end of the sheath tube near end (102), wherein a catheter device (504) is arranged on the expansion tube connector (5), and the catheter device (504) can irrigate the irrigation channel (8) with irrigation water and/or operation instruments;

the negative pressure output device (6) is connected with the end part of the outer opening of the sheath tube near end (102), and the negative pressure output device (6) is communicated with the negative pressure channel (7) in a sealing way;

wherein the sheath (1) comprises:

the distal end of the outer sheath tube (2) is provided with a puncture tip, and the outer sheath tube (2) is an expandable sheath tube;

the inner sheath tube (3) is sleeved inside the outer sheath tube (2), the inner sheath tube (3) is tightly attached to the outer sheath tube (2), and the inner sheath tube (3) can rotate and/or move relative to the outer sheath tube (2);

the negative pressure channel (7) and the perfusion channel (8) are arranged inside the inner sheath tube (3), the negative pressure channel (7) and the perfusion channel (8) are separated by a partition wall (302), the partition wall (302) can be flexibly deformed when in use and is used for adjusting the cross section of the negative pressure channel (7) and the perfusion channel (8), the perfusion channel (8) forms a first connecting part (10) at the proximal end of the inner sheath tube (3), and the first connecting part (10) is connected with the expansion tube joint (5) in a sealing way; the negative pressure channel (7) forms a second connecting part (11) at the near end of the inner sheath tube (3), and the second connecting part (11) is connected with the negative pressure output device (6) in a sealing way;

the inner sheath (3) comprises:

an inner sheath wall (301) arranged in a circular tube shape and serving as an expandable sheath wall;

the two ends of the partition wall (302) are connected with the inner wall of the inner sheath tube wall (301), and the partition wall (302) is arranged in an arc shape or a spline curve shape;

the working port (304) is arranged at the far end of the inner sheath tube wall (301), the projection of the contour line of the working port (304) is arranged in an inclined straight line or arc line, the working port (304) comprises a suction port (304a) and an irrigation port (304b), the suction port (304a) is communicated with the negative pressure channel (7), the irrigation port (304b) is communicated with the irrigation channel (8), and the irrigation port (304b) is arranged on one side, close to the near end of the inner sheath tube wall (301), of the working port (304);

the value range of the ratio of the cross-sectional area of a negative pressure channel (7) separated in an inner sheath tube wall (301) to the cross-sectional area of a perfusion channel (8) by a partition wall (302) in an initial state is 2-8, a connection cover (9) is arranged at the far end of the inner sheath tube wall (301), the connection cover (9) covers a suction port (304a), a suction liquid port (904) is arranged on the connection cover (9), the suction liquid port (904) and the suction channel of the suction port (304a) are arranged in an included angle mode, the hardness of the partition wall (302) is smaller than that of the inner sheath tube wall (301), and the hardness of the far end of the inner sheath tube wall (301) is smaller than that of the near end of the inner sheath tube wall (301).

2. The percutaneous renal ultramicro-channel visual puncture dilation integrated kit with negative pressure suction function according to claim 1, wherein the first connection part (10) comprises:

a first connection boss (1001) provided outside a proximal end of the inner sheath tube wall (301);

a first external thread (1002) provided outside the first connection boss (1001) for screw-sealing with a first internal thread (5013) on the expansion pipe joint (5).

3. The percutaneous renal ultramicro channel visual puncture dilation integrated kit with negative pressure suction function according to claim 2, wherein the second connecting part (11) comprises:

a first connecting tube part (1102) integrally formed with the proximal end of the negative pressure channel (7) in the inner sheath tube (3);

a diameter-variable portion (1103) for converting the first connecting tube portion (1102) into a circular connecting tube;

a second connecting pipe portion (1104) provided on a side of the diameter-variable portion (1103) away from the first connecting pipe portion (1102);

a lumen (1101) which penetrates the second connecting tube part (1104), the reducing part (1103) and the first connecting tube part (1102) and communicates with the negative pressure passage (7);

the second external thread (1105) is arranged on the outer surface of the end part of the second connecting pipe part (1104) far away from the diameter-variable part (1103) and is used for being in threaded sealing connection with the head plate (14);

and the second internal thread (1106) is arranged on the inner surface of the end opening of the second connecting pipe part (1104) far away from the variable-diameter part (1103) and is used for being in threaded sealing connection with the negative pressure output device (6).

4. The visible puncture and dilation integrated kit for percutaneous renal ultramicro-channel with negative pressure suction function according to claim 3, wherein the dilation tube joint (5) comprises:

a first annular connection portion (501) for sealing connection with the first connection portion (10);

an arcuate enlargement (502), the catheter device (504) being disposed on the arcuate enlargement (502);

a second annular connecting part (503) which is arranged at one end of the arc-shaped enlarged part (502) far away from the first annular connecting part (501), and the second connecting part (11) extends out of the proximal end part of the second annular connecting part (503);

the end sealing plate (14) is connected with the second connecting part (11) in a sealing mode, and the outer edge of the end sealing plate (14) is connected with the port of the second annular connecting part (503) in a sealing mode;

the cross-sectional area of the arc-shaped enlarged part (502) is gradually increased from one side close to the first annular connecting part (501) to one side close to the second annular connecting part (503).

5. The negative-pressure-suction percutaneous renal ultramicro-channel visual puncture and dilation integrated kit according to claim 4, wherein the negative-pressure-suction percutaneous renal ultramicro-channel visual puncture and dilation integrated kit further comprises:

the pull wire ring (12) is arranged on the inner wall of the inner sheath tube wall (301) close to the position of the far-end outlet and is connected with the inner sheath tube (3) into a whole;

the far end of the pull wire (13) is fixedly connected with the pull wire ring (12), and the near end of the pull wire is fixedly connected with the adjusting piece (505);

the adjusting piece (505) is arranged on the expansion pipe joint (5) and can drive the pull wire (13) to move to one side so as to bend the far end of the inner sheath pipe (3) to one side;

wherein the adjusting piece (505) comprises:

the winding ring (5051) is sleeved on the fixed shaft (5012), the winding ring (5051) can be pushed or pulled relative to the fixed shaft (5012), in the pushing state, the winding ring (5051) can rotate relative to the fixed shaft (5012) through a bearing, in the pulling state, the winding ring (5051) is fixed relative to the fixed shaft (5012), and the fixed shaft (5012) is fixed on the outer surface of the pipe wall (5011) of the connecting part;

a winding slot (5052) which is provided in the form of an annular slot and can accommodate a wound wire (13);

and the adjusting handle (5053) is fixedly connected with the winding ring (5051) and is used for rotating the winding ring (5051).

6. The percutaneous renal ultramicro-channel visual puncture dilation integrated kit with negative pressure suction function according to claim 5, wherein the head sealing plate (14) comprises:

a plate body (1401) for covering an end opening of the second annular connecting portion (503);

a connection base (1405) provided on one side of the plate body (1401) for covering an opening between the outside of the second connection pipe portion (1104) and the inside of the second annular connection portion (503);

the connecting hole (1402) penetrates through the plate body (1401) and the connecting table (1405), and the connecting hole (1402) is communicated with a negative pressure channel (7);

a third internal thread (1403) which is arranged inside the connecting hole (1402) and is in threaded connection with the second external thread (1105) on the second connecting part (11);

a sealing rib (1406) disposed on an outer surface of the connection platform (1405).

7. The percutaneous renal ultramicro-channel visual puncture dilation integrated kit with negative pressure suction function according to claim 6, wherein the negative pressure output device (6) comprises:

the negative pressure connecting pipe (603) comprises a third connecting end (604), a third connecting external thread (605) is arranged on the outer surface of the third connecting end (604), and the third connecting external thread (605) is in threaded connection with a second internal thread (1106) on the second connecting part (11);

a negative pressure suction pipe (601) which is communicated with the negative pressure channel (7) and can generate negative pressure suction force at the suction port (304a) under the action of a negative pressure source (602);

and a finger covering groove (607) arranged on the negative pressure suction pipe (601), wherein a negative pressure adjusting hole (608) is arranged in the finger covering groove (607).