CN113616316A - Bladder tumor en-block monoblock excision device based on resectoscope - Google Patents
Bladder tumor en-block monoblock excision device based on resectoscope Download PDFInfo
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- CN113616316A CN113616316A CN202110912184.9A CN202110912184A CN113616316A CN 113616316 A CN113616316 A CN 113616316A CN 202110912184 A CN202110912184 A CN 202110912184A CN 113616316 A CN113616316 A CN 113616316A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
- A61B90/14—Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
- A61B90/17—Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins for soft tissue, e.g. breast-holding devices
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00505—Urinary tract
- A61B2018/00517—Urinary bladder or urethra
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00601—Cutting
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00982—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
Abstract
The invention discloses a resection device for integrally cutting bladder tumor en-block based on an resectoscope, which relates to the technical field of medical instruments and has the technical scheme that: the device comprises a control box body, wherein an observation device, an electric control device, a water quantity adjusting device and a tumor supporting device are arranged in the control box body, and the water quantity adjusting device comprises a water inlet adjusting valve, a water outlet adjusting valve, a water inlet pipe, a water outlet pipe, an annular collecting bin and a separating device. The resectoscope cystoma en-block monoblock resection device can inject normal saline into the bladder through the water quantity adjusting device, so that the bladder filling degree is maintained for a long time under the condition of not influencing the visual field; meanwhile, the device realizes the traction of the tumor through the tumor supporting device, and achieves the effect of continuously manufacturing adjustable tension; in addition, by arranging the annular collecting bin and the separating device, the real-time collection of the target excised tissues can be realized.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a bladder tumor en-block monoblock resection device based on an resectoscope.
Background
Bladder tumors are highly prevalent, with 75% of new bladder malignancies being non-muscle invasive bladder cancer (NMIBC). For NMIBC, transurethral cystocele (plasma) electrosection is the most common treatment modality. The urethra and bladder tumor (plasma) electrosection directly determines the curative effect of the NMIBC treatment and the prognosis of the patient. At present, a segmental resection method is usually adopted in clinical NMIBC (human brain surgery) electrotomy, but segmental resection easily causes tumor residues, electrocautery is carried out on tumor tissues to cause eschar to form layers which are difficult to identify, the integrity of tissue structures is damaged, and the omission and stage deviation of high-grade malignant tumor components caused by pathology when the minced tissues are sent for biopsy are easily caused. The literature reports that after NMIBC electrosurgery, considerable tumor recurrence is caused by tumor residues, particularly medium and high grade bladder cancer of T1 stage, the tumor residue rate can reach 33.8% -36%, and in addition, pathological stage deviation of a part of tumors can be caused for the first time due to the quality problems of electrosection technology and tumor specimens sent and detected.
In order to solve the problems, the conventional segmental resection is mainly replaced by an en-block monoblock resection method in the medical field at present, the method can realize complete resection of bladder tumors and bladder mucous membranes and muscle layers of the region where the tumors are located, the purpose of fully preserving complete tissue structures and bases is achieved, the tumor recurrence rate is well reduced, and the accuracy of tumor pathological diagnosis is improved. However, no medical instrument specially used for en-block excision of bladder tumors exists at present. En-block ablation of bladder tumors using laser access and conventional resectoscope are currently two major approaches. However, the use of laser requires additional purchase of laser equipment and related consumables, which increases the cost; subcutaneous water injection is required in advance during the operation, so that the operation procedure is complicated and the operation time is increased; and are difficult to treat, frequently (> 5), especially stolonically growing tumors. Although the traditional resectoscope for bladder tumor en-block resection can be used without newly purchasing equipment and increasing consumables in operation, and can treat multiple polymorphic tumors in a mode of combining en-block resection and traditional segmental resection, the traditional resectoscope for bladder tumor en-block resection has the 3 main problems that the proper tension for the tumor is difficult to obtain so as to realize accurate layer separation, the proper filling degree of the bladder is difficult to maintain for a long time so as to avoid the influence of frequent water drainage or water inflow regulation on the visual field, and the target lesion tissue is accurately cut and accurately collected in real time so as to avoid the target cutting tissue from being mixed into other cutting tissue fragments.
In order to enable the prior transurethral resection device to be better applied to the enblock resection of bladder tumors, the invention creatively improves the prior transurethral resection device, so that the device can realize the traction of tumors, continuously produce adjustable tension, maintain the bladder fullness for a long time under the condition of not influencing the visual field, and simultaneously realize the real-time collection of target resection tissues. So that the surgeon can better perform the en-block excision operation of the bladder tumor.
Disclosure of Invention
The invention aims to provide a resection device based on an resectoscope bladder tumor en-block in a whole block, which can inject normal saline into a bladder while cutting a tumor, regulate and control the water injection amount in the bladder, keep the bladder in a stable filling state and conveniently ensure that a clear visual field is provided when the tumor is cut; simultaneously, the device easy operation is convenient, and can absorb the collection to the tumour fragment after the tumour cutting.
The technical purpose of the invention is realized by the following technical scheme: the bladder tumor en-block monoblock resection device based on the resectoscope comprises a control box body, wherein an inner sheath and an outer sheath are arranged at the end part of the control box body, the inner sheath and the outer sheath are both hollow cylinders, and the outer sheath is sleeved outside the inner sheath; an observation device, an electric control device and a water quantity adjusting device are arranged in the control box body, an electric cutting ring is arranged at the output end of the electric control device, and the electric cutting ring is positioned at the end part of the outer sheath far away from the control box body; the observation device comprises an eyepiece, a focusing device, a lens barrel and an endoscope; one end of the lens cone is connected with the control box body, one end of the lens cone, which is far away from the control box body, is connected with the focusing device, and one end of the adjusting device, which is far away from the lens cone, is connected with the eyepiece; one end of the endoscope is positioned in the control box body and is connected with the lens cone, and the end, far away from the control box body, of the endoscope penetrates through the end parts of the inner sheath and the outer sheath and is positioned outside the device; the water quantity adjusting device comprises a water inlet adjusting valve, a water outlet adjusting valve, a water inlet pipe, a water outlet pipe, an annular collecting bin and a separating device, wherein one end of the water inlet pipe penetrates through the side wall of the sheath to be communicated with the outside of the tumor resection device, the other end of the water inlet pipe penetrates through the control box body to be communicated with the outside of the tumor resection device, and the water inlet adjusting valve is connected with the side wall of the water inlet pipe; the outer side wall of the annular collecting bin is fixedly connected with the inner side wall of the outer sheath, a liquid inlet communicated with the outside of the tumor resection device is formed in the side wall of the annular collecting bin, one end of the water outlet pipe is connected with the annular collecting bin, and the other end of the water outlet pipe penetrates through the separation device to be communicated with the outside of the tumor resection device; the water outlet regulating valve is connected with the side wall of the water outlet pipe.
By adopting the technical scheme, the water quantity adjusting device is arranged in the control box body, and the physiological saline water quantity in the bladder can be controlled by the water quantity adjusting device, so that the visual field effect of the resectioning ring in the tumor cutting process can be improved, and the cut tumor blocks can be collected and separated; by installing the observation device in the control box body, an operator can observe the state of the inside of the bladder through the ocular lens; by adjusting the focusing device, the definition of the eyepiece can be adjusted according to different conditions.
The invention is further configured to: the separation device comprises an L-shaped sliding plate, a handle, a filter screen and a tumor block storage; the outer side wall of the tumor mass storage is fixedly connected with the inner side wall of the control box body, the water outlet pipe penetrates through two opposite side walls of the tumor mass storage, and the filter screen is positioned at the end part of the water outlet pipe close to the water outlet end of the tumor mass storage; the utility model discloses a tumor mass storage device, including tumor mass storage, handle and L shape slide, the relative lateral wall of tumor mass storage is equipped with two U-shaped spouts, the horizontal segment of L shape slide is located the U-shaped spout, the lateral wall of the vertical section of L shape slide and the lateral wall parallel and level of tumor mass storage, the lateral wall fixed connection of the vertical section of handle and L shape slide.
By adopting the technical scheme, the water outlet pipe penetrates through two opposite side walls of the tumor mass storage, and the end part of the water outlet pipe close to the water outlet end of the tumor mass storage is provided with the filter screen, so that the normal saline entering the tumor mass storage from the water outlet pipe and the tumor fragments can be separated at the filter screen; the L-shaped sliding plate is arranged at the bottom of the tumor mass storage, so that the tumor fragments can be collected and can be conveniently taken out.
The invention is further configured to: the electric control device comprises an electric control box body, an electric control pipeline, a rotating shaft, a first ejector rod, an insulating block, a connecting guide rod, a switch contact, a transformer and a power line socket; the bottom of the electric control box body is fixedly connected with the bottom of the control box body, one end of the electric control pipeline penetrates through the electric control box body and is connected with the connecting guide rod through the rotating shaft, and the other end of the electric control pipeline penetrates through the end part, far away from the control box body, of the outer sheath and is connected with the electric cutting ring; the side wall of the connecting guide rod is provided with a first sliding groove, a first roller is arranged in the first sliding groove, a rotating shaft of the first roller is connected with the side wall of a first ejector rod, the bottom of the first ejector rod is fixedly connected with the top of an insulating block, and the bottom of the insulating block is provided with a pressing device; the transformer is fixedly connected with the bottom of the electric control box body, the bottom of the transformer is connected with a power line socket, the power line socket is located on the outer side of the electric control box body, and the output end of the transformer is connected with the switch contact.
Through adopting above-mentioned technical scheme, be connected press device and insulating block, and the connecting rod passes through ejector pin one and is connected with the insulating block, can control whole electrically controlled device's switch through press device to the circular telegram condition of control electricity surely.
The invention is further configured to: the pressing device comprises a pressing handle, a hollow grip, a connecting block, an arc-shaped sliding block, an inclined block and a top block, wherein the pressing handle is hinged with the hollow grip, one end of the connecting block is fixedly connected with the side wall of the pressing handle, the other end of the connecting block is fixedly connected with the end part of the arc-shaped sliding block, and the arc-shaped sliding block is positioned in the hollow grip; the side wall of the arc-shaped sliding block is in contact with the sloping block, the end part, far away from the connecting block, of the arc-shaped sliding block is in contact with the bottom of the ejector block, the side wall of the sloping block is fixedly connected with the inner side wall of the hollow handle, the outer side wall of the ejector block is movably connected with the inner side wall of the hollow handle, and the top of the ejector block is fixedly connected with the bottom of the insulating block.
Through adopting above-mentioned technical scheme, press handle and cavity handle articulated, and set up arc slider and kicking block in the cavity handle, can make electrically controlled device circular telegram through pressing down the handle to the effect of manual control electricity surely encircles the circular telegram has been realized.
The invention is further configured to: a tumor supporting device is arranged in the control box body and comprises a control device and a swinging device, wherein the control device comprises a knob, a rotating rod, a gear, a transmission rod and a limiting block; the rotary knob is in contact with the outer side wall of the control box body, a rotating shaft of the rotary knob is connected with a rotating shaft of the gear through a rotating rod, and the gear is meshed with the side wall of the transmission rod; one end of the transmission rod is located in the control box body, the end, far away from the control box body, of the transmission rod penetrates through the limiting block to be connected with the swinging device, and the side wall of the limiting block is fixedly connected with the inner side wall of the outer sheath.
Through adopting above-mentioned technical scheme, through adjust knob, can realize the pendulous device luffing motion for the pendulous device is with tumour jack-up, reaches the effect of being convenient for to the tumour cutting.
The invention is further configured to: the swinging device comprises a second ejector rod and a transmission shaft; the side wall of the sheath close to the second ejector rod is provided with a swing groove, the second ejector rod penetrates through the swing groove and is hinged with the side wall of the sheath, the side wall of the second ejector rod is provided with a second sliding groove, the second roller is located in the second sliding groove, and a rotating shaft of the second roller is fixedly connected with the side wall of the transmission rod through a transmission shaft.
Through adopting above-mentioned technical scheme, drive the transfer line back-and-forth movement through the knob, the transfer line drives two gyro wheels and removes in two spouts to realize two ejector pins luffing motion in the swing inslot, two ejector pins can be with tumour jack-up, reach the effect that makes things convenient for medical personnel to cut the root of tumour.
In conclusion, the invention has the following beneficial effects:
1. the water quantity adjusting device is arranged in the control box body, and the physiological saline quantity in the bladder can be controlled by the water quantity adjusting device, so that the visual field effect of the electrotomy ring in the tumor cutting process can be improved, and the cut tumor blocks can be collected and separated;
2. by installing the observation device in the control box body, an operator can observe the state of the inside of the bladder through the ocular lens; the definition presented by the eyepiece can be adjusted according to different conditions by adjusting the focusing device;
3. through the tumor supporting device, the tumor is jacked up or pulled to a proper position for fixation by means of tension, and the tumor is cut conveniently.
Drawings
FIG. 1 is a schematic structural diagram of an integral excision-scope-based bladder tumor en-block resection device in the embodiment of the invention;
FIG. 2 is an enlarged view at A in FIG. 1;
FIG. 3 is an enlarged view at B in FIG. 1;
FIG. 4 is an enlarged view at C of FIG. 1;
FIG. 5 is an enlarged view at D of FIG. 1;
FIG. 6 is a schematic structural diagram of an oscillating device based on an resectoscope bladder tumor en-block monoblock resection device in the embodiment of the invention.
In the figure: 1. an endoscope; 2. an inner sheath; 3. an electric control pipeline; 4. pressing the handle; 5. a hollow grip; 6. a water inlet pipe; 7. a water inlet regulating valve; 8. a water outlet regulating valve; 9. an eyepiece; 10. a focusing device; 11. a lens barrel; 12. a control box body; 13. a knob; 14. a water outlet pipe; 15. an outer sheath; 16. a transmission rod; 17. a limiting block; 18. a swing groove; 19. a second ejector rod; 20. electrically cutting a ring; 21. an annular collection bin; 22. a liquid inlet; 23. an electric control box body; 24. connecting the guide rod; 25. a first sliding chute; 26. a first roller; 27. an insulating block; 28. a top block; 29. a first ejector rod; 30. a power line socket; 31. a transformer; 32. a switch contact; 33. a rotating shaft; 34. connecting blocks; 35. an arc-shaped sliding block; 36. a sloping block; 37. a tumor mass reservoir; 38. a handle; 39. a U-shaped chute; 40. a filter screen; 41. an L-shaped slide plate; 42. a gear; 43. a second chute; 44. a second roller; 45. a drive shaft; 46. the rod is rotated.
Detailed Description
The invention is described in further detail below with reference to figures 1-6.
Example (b): an integral excision-scope-based bladder tumor en-block resection device is shown in figures 1 to 6 and comprises a control box body 12, wherein an inner sheath 2 and an outer sheath 15 are fixedly arranged at the end part of the control box body 12, the inner sheath 2 and the outer sheath 15 are both hollow cylinders, and the outer sheath 15 is sleeved outside the inner sheath 2; an observation device, an electric control device and a water quantity adjusting device are arranged in the control box body 12, an electric cutting ring 20 is fixedly arranged at the output end of the electric control device, and the electric cutting ring 20 is positioned at the end part of the outer sheath 15 far away from the control box body 12; the observation device comprises an eyepiece 9, a focusing device 10, a lens barrel 11 and an endoscope 1; one end of the lens barrel 11 is fixedly connected with the control box body 12, one end of the lens barrel 11, which is far away from the control box body 12, is fixedly connected with the focusing device 10, and one end of the adjusting device, which is far away from the lens barrel 11, is fixedly connected with the eyepiece 9; one end of the endoscope 1 is positioned in the control box body 12, the endoscope 1 is fixedly connected with the lens cone 11, and one end of the endoscope 1, which is far away from the control box body 12, penetrates through the end parts of the inner sheath 2 and the outer sheath 15 and is positioned outside the device; the water quantity regulating device comprises a water inlet regulating valve 7, a water outlet regulating valve 8, a water inlet pipe 6, a water outlet pipe 14, an annular collecting bin 21 and a separating device, one end of the water inlet pipe 6 penetrates through the side wall of the outer sheath 15 to be communicated with the outside of the tumor resection device, the other end of the water inlet pipe 6 penetrates through the control box body 12 to be communicated with the outside of the tumor resection device, and the water inlet regulating valve 7 is connected with the side wall of the water inlet pipe 6; the outer side wall of the annular collecting bin 21 is fixedly connected with the inner side wall of the outer sheath 15, a liquid inlet 22 communicated with the outside of the tumor resection device is installed on the side wall of the annular collecting bin 21, one end of a water outlet pipe 14 is connected with the annular collecting bin 21, and the other end of the water outlet pipe 14 penetrates through the separation device to be communicated with the outside of the tumor resection device; the water outlet regulating valve 8 is connected with the side wall of the water outlet pipe 14.
In the embodiment, when a medical staff performs bladder tumor cutting, the endoscope 1 is positioned in the bladder, the endoscope 1 transmits the visual field to the lens barrel 11, and when the visual field is transmitted to the ocular lens 9 through the endoscope 1 by the focusing device 10, the medical staff observes the conditions in the bladder through the ocular lens 9; in the observation process, the medical staff can control the definition by adjusting the focusing device 10 and finally cut the bladder tumor by the resectoscope; when the internal condition of the bladder is observed, if the visual field in the bladder is not good enough, the medical staff can adjust the water inlet adjusting valve 7 to increase the water inlet flow, and adjust the water outlet adjusting valve 8 to reduce the water outlet flow, so that the physiological saline in the bladder is increased, and the visual field definition of the medical staff is improved; when the electric cutting ring 20 is used for cutting tumors, fragments of the tumors enter the water outlet pipe 14 along with the physiological saline and then enter the separation device, the fragments of the tumors are remained in the separation device, and the physiological saline is discharged to the outside of the tumor resection device from the water outlet pipe 14; in this embodiment, the outer sheath is hollow and cylindrical, and has a size of 20Fr-22Fr, which is shaped and dimensioned to enable the device to be passed through the urethra into the bladder.
The separating device comprises an L-shaped sliding plate 41, a handle 38, a filter screen 40 and a tumor mass storage 37; the outer side wall of the tumor mass storage 37 is fixedly connected with the inner side wall of the control box body 12, the water outlet pipe 14 penetrates through two opposite side walls of the tumor mass storage 37, and the filter screen 40 is positioned at the end part of the water outlet pipe 14 close to the water outlet end of the tumor mass storage 37; the relative lateral wall of tumour piece accumulator 37 is opened there are two U-shaped spout 39, and the horizontal section of L shape slide 41 is located U-shaped spout 39, and the lateral wall of the vertical section of L shape slide 41 is parallel and level with the lateral wall of tumour piece accumulator 37, and handle 38 is fixed connection with the lateral wall of the vertical section of L shape slide 41.
In this embodiment, the tumor fragments and the physiological saline enter the tumor mass storage 37 at the same time, due to the action of the filter screen 40, the filter screen 40 can filter the tumor fragments, and finally the tumor fragments fall on the bottom of the L-shaped sliding plate 41, after the tumor is cut, the medical staff can pull the handle 38 to take out the L-shaped sliding plate 41, pour the tumor mass, and then insert the L-shaped sliding plate 41 into the tumor mass storage 37; in this embodiment, the L-shaped sliding plate 41 slides along the U-shaped sliding slot 39, and when the outer side wall of the vertical section of the L-shaped sliding plate 41 is flush with the outer side wall of the control box 12, a sealing state is achieved.
The electric control device comprises an electric control box body 23, an electric control pipeline 3, a rotating shaft 33, a first ejector rod 29, an insulating block 27, a connecting guide rod 24, a switch contact 32, a transformer 31 and a power line socket 30; the bottom of the electric control box body 23 is fixedly connected with the bottom of the control box body 12, one end of the electric control pipeline 3 penetrates through the electric control box body 23 and is connected with the connecting guide rod 24 through the rotating shaft 33, and the other end of the electric control pipeline 3 penetrates through the end part of the outer sheath 15 far away from the control box body 12 and is connected with the electric cutting ring 20; the side wall of the connecting guide rod 24 is provided with a first sliding groove 25, the inside of the first sliding groove 25 is in sliding connection with a first roller 26, a rotating shaft 33 of the first roller 26 is movably connected with the side wall of a first ejector rod 29, the bottom of the first ejector rod 29 is fixedly connected with the top of an insulating block 27, and the bottom of the insulating block 27 is provided with a pressing device; the transformer 31 is fixedly connected with the bottom of the electric control box body 23, the bottom of the transformer 31 is connected with the power line socket 30, the power line socket 30 is positioned outside the electric control box body 23, and the output end of the transformer 31 is connected with the switch contact 32.
In this embodiment, during the process of cutting a tumor, when the resectoscope ring 20 is close to the bottom of the tumor, the ejector block 28 moves upwards along the hollow handle 5, the ejector block 28 drives the insulation block 27 to move upwards, the insulation block 27 drives the ejector rod 29 to move upwards, the ejector rod 29 moves upwards in the moving process, so that the roller 26 slides in the sliding groove 25, at this time, the connecting guide rod 24 rotates upwards around the rotating shaft 33, when the connecting guide rod 24 is connected with the switch contact 32, the current output from the transformer 31 passes through the resectoscope ring 20, the resectoscope ring 20 is powered on to cut the tumor in the bladder, after the tumor is cut off, the ejector block 28 moves downwards along the hollow handle 5, so that the connecting guide rod 24 is disconnected from the switch contact 32, and at this time, the resectoscope ring 20 is not powered on.
The pressing device comprises a pressing handle 4, a hollow handle 5, a connecting block 34, an arc-shaped sliding block 35, an inclined block 36 and a top block 28, wherein the pressing handle 4 is hinged with the hollow handle 5, one end of the connecting block 34 is fixedly connected with the side wall of the pressing handle 4, the other end of the connecting block 34 is fixedly connected with the end part of the arc-shaped sliding block 35, and the arc-shaped sliding block 35 is positioned in the hollow handle 5; the lateral wall of arc slider 35 contacts with sloping block 36, and the tip that arc slider 35 kept away from connecting block 34 contacts with the bottom of kicking block 28, and the lateral wall and the inside wall fixed connection of cavity handle 5 of sloping block 36, the outside wall and the inside wall swing joint of cavity handle 5 of kicking block 28, the top of kicking block 28 and the bottom fixed connection of insulating block 27.
In this embodiment, when the resectoscope 20 is located at the root of a tumor, a medical staff presses the pressing handle 4, the pressing handle 4 drives the connecting block 34 to move towards the hollow handle 5, the hollow handle 5 drives the arc-shaped sliding block 35 to move along the inclined plane of the inclined block 36, the end of the arc-shaped sliding block 35 jacks up the ejector block 28, so that the ejector block 28 moves upwards along the hollow handle 5, thereby realizing that the connecting guide rod 24 is connected with the switch contact 32, and electrifying the resectoscope 20.
A tumor supporting device is arranged in the control box body 12 and comprises a control device and a swinging device, wherein the control device comprises a knob 13, a rotating rod 46, a gear 42, a transmission rod 16 and a limiting block 17; the knob 13 is contacted with the outer side wall of the control box body 12, the rotating shaft 33 of the knob 13 is connected with the rotating shaft 33 of the gear 42 through a rotating rod 46, and the gear 42 is meshed with the side wall of the transmission rod 16; one end of the transmission rod 16 is positioned in the control box body 12, the end part of the transmission rod 16 far away from the control box body 12 penetrates through the limiting block 17 to be connected with the swinging device, and the side wall of the limiting block 17 is fixedly connected with the inner side wall of the outer sheath 15.
In this embodiment, when a tumor is cut, the end of the second post rod 19 is located at the tumor, and at this time, the medical staff rotates the knob 13, the rotating knob 13 drives the gear 42 to rotate through the rotating rod 46, the gear 42 drives the transmission rod 16 to move rightward along the horizontal direction, because the limiting block 17 is fixed on the inner side wall of the outer sheath 15, the transmission rod 16 only reciprocates horizontally, and thus the swinging device swings.
The swinging device comprises a second ejector rod 19 and a transmission shaft 45; the side wall of the outer sheath 15 close to the second ejector rod 19 is provided with a swing groove 18, the second ejector rod 19 penetrates through the swing groove 18 and is hinged with the side wall of the outer sheath 15, the side wall of the second ejector rod 19 is provided with a second sliding groove 43, the second roller 44 is positioned in the second sliding groove 43, and the rotating shaft 33 of the second roller 44 is fixedly connected with the side wall of the transmission rod 16 through a transmission shaft 45.
In this embodiment, when the transmission rod 16 drives the second roller 44 to roll in the second sliding slot 43 through the transmission shaft 45, since one end of the second push rod 19 is hinged to the inner side wall of the outer sheath 15, the second push rod 19 can swing up and down.
The working principle is as follows: by installing the water quantity adjusting device in the control box body 12, the physiological saline quantity in the bladder can be controlled by adjusting the water quantity adjusting device, so that the visual field effect of the electrotomy ring 20 in the tumor cutting process can be improved, and the cut tumor blocks can be collected and separated; by installing the observation device in the control box body 12, the operator can observe the state of the inside of the bladder through the ocular lens 9; by adjusting the focusing device 10, the sharpness presented by the eyepiece 9 can be adjusted according to different situations.
The present embodiment is only for explaining the present invention, and it is not limited to the present invention, and those skilled in the art can make modifications of the present embodiment without inventive contribution as needed after reading the present specification, but all of them are protected by patent law within the scope of the claims of the present invention.
Claims (6)
1. The utility model provides a based on whole resection device of resectoscope bladder tumour en-block, includes control box (12), characterized by: an inner sheath (2) and an outer sheath (15) are arranged at the end part of the control box body (12), the inner sheath (2) and the outer sheath (15) are both hollow cylinders, and the outer sheath (15) is sleeved outside the inner sheath (2); an observation device, an electric control device and a water quantity adjusting device are arranged in the control box body (12), an electric cutting ring (20) is arranged at the output end of the electric control device, and the electric cutting ring (20) is positioned at the end part of the outer sheath (15) far away from the control box body (12); the observation device comprises an eyepiece (9), a focusing device (10), a lens barrel (11) and an endoscope (1); one end of the lens barrel (11) is connected with the control box body (12), one end of the lens barrel (11) far away from the control box body (12) is connected with the focusing device (10), and one end of the adjusting device far away from the lens barrel (11) is connected with the eyepiece (9); one end of the endoscope (1) is positioned in the control box body (12), the endoscope (1) is connected with the lens cone (11), and one end, far away from the control box body (12), of the endoscope (1) penetrates through the end parts of the inner sheath (2) and the outer sheath (15) to be positioned outside the device;
the water quantity adjusting device comprises a water inlet adjusting valve (7), a water outlet adjusting valve (8), a water inlet pipe (6), a water outlet pipe (14), an annular collecting bin (21) and a separating device, one end of the water inlet pipe (6) penetrates through the side wall of an outer sheath (15) to be communicated with the outside of the tumor resection device, the other end of the water inlet pipe (6) penetrates through a control box body (12) to be communicated with the outside of the tumor resection device, and the water inlet adjusting valve (7) is connected with the side wall of the water inlet pipe (6); the outer side wall of the annular collecting bin (21) is fixedly connected with the inner side wall of the outer sheath (15), a liquid inlet (22) communicated with the outside of the tumor resection device is formed in the side wall of the annular collecting bin (21), one end of the water outlet pipe (14) is connected with the annular collecting bin (21), and the other end of the water outlet pipe (14) penetrates through the separation device to be communicated with the outside of the tumor resection device; the water outlet regulating valve (8) is connected with the side wall of the water outlet pipe (14).
2. The resected device based on an resectoscope bladder tumor en-block as recited in claim 1, wherein: the separation device comprises an L-shaped sliding plate (41), a handle (38), a filter screen (40) and a tumor mass storage (37); the outer side wall of the tumor mass storage (37) is fixedly connected with the inner side wall of the control box body (12), the water outlet pipe (14) penetrates through two opposite side walls of the tumor mass storage (37), and the filter screen (40) is positioned at the end part, close to the water outlet end of the tumor mass storage (37), of the water outlet pipe (14); the relative lateral wall of tumour piece accumulator (37) is equipped with two U-shaped spout (39), the horizontal segment of L shape slide (41) is located U-shaped spout (39), the lateral wall of the vertical section of L shape slide (41) is the parallel and level with the lateral wall of tumour piece accumulator (37), handle (38) and the lateral wall fixed connection of the vertical section of L shape slide (41).
3. The resected device based on an resectoscope bladder tumor en-block as recited in claim 1, wherein: the electric control device comprises an electric control box body (23), an electric control pipeline (3), a rotating shaft (33), a first ejector rod (29), an insulating block (27), a connecting guide rod (24), a switch contact (32), a transformer (31) and a power line socket (30); the bottom of the electric control box body (23) is fixedly connected with the bottom of the control box body (12), one end of the electric control pipeline (3) penetrates through the electric control box body (23) and is connected with the connecting guide rod (24) through a rotating shaft (33), and the other end of the electric control pipeline (3) penetrates through the end part of the outer sheath (15) far away from the control box body (12) and is connected with the electric cutting ring (20); a first sliding groove (25) is formed in the side wall of the connecting guide rod (24), a first roller (26) is arranged in the first sliding groove (25), a rotating shaft (33) of the first roller (26) is connected with the side wall of a first ejector rod (29), the bottom of the first ejector rod (29) is fixedly connected with the top of an insulating block (27), and a pressing device is arranged at the bottom of the insulating block (27); the transformer (31) is fixedly connected with the bottom of the electric control box body (23), the bottom of the transformer (31) is connected with a power line socket (30), the power line socket (30) is located on the outer side of the electric control box body (23), and the output end of the transformer (31) is connected with a switch contact (32).
4. The resected device of claim 3 based on an resectoscope bladder tumor en-block monoblock, wherein: the pressing device comprises a pressing handle (4), a hollow handle (5), a connecting block (34), an arc-shaped sliding block (35), an inclined block (36) and a top block (28), wherein the pressing handle (4) is hinged to the hollow handle (5), one end of the connecting block (34) is fixedly connected with the side wall of the pressing handle (4), the other end of the connecting block (34) is fixedly connected with the end part of the arc-shaped sliding block (35), and the arc-shaped sliding block (35) is located in the hollow handle (5); the lateral wall and the sloping block (36) of arc slider (35) touch and connect, the tip that connecting block (34) were kept away from in arc slider (35) touches and connects with the bottom of kicking block (28), the lateral wall and the inside wall fixed connection of cavity handle (5) of sloping block (36), the lateral wall and the inside wall swing joint of cavity handle (5) of kicking block (28), the top of kicking block (28) and the bottom fixed connection of insulating block (27).
5. The resected device based on an resectoscope bladder tumor en-block as recited in claim 1, wherein: a tumor supporting device is arranged in the control box body (12), the tumor supporting device comprises a control device and a swinging device, and the control device comprises a knob (13), a rotating rod (46), a gear (42), a transmission rod (16) and a limiting block (17); the rotary knob (13) is in contact with the outer side wall of the control box body (12), the rotating shaft (33) of the rotary knob (13) is connected with the rotating shaft (33) of the gear (42) through a rotating rod (46), and the gear (42) is meshed with the side wall of the transmission rod (16); one end of the transmission rod (16) is positioned in the control box body (12), the end part, far away from the control box body (12), of the transmission rod (16) penetrates through the limiting block (17) to be connected with the swinging device, and the side wall of the limiting block (17) is fixedly connected with the inner side wall of the outer sheath (15).
6. The resectoscope-based en-block resection device of claim 5, wherein: the swinging device comprises a second ejector rod (19) and a transmission shaft (45); the side wall of the outer sheath (15) close to the second ejector rod (19) is provided with a swing groove (18), the second ejector rod (19) penetrates through the swing groove (18) to be hinged with the side wall of the outer sheath (15), the side wall of the second ejector rod (19) is provided with a second sliding groove (43), the second roller (44) is located in the second sliding groove (43), and the rotating shaft (33) of the second roller (44) is fixedly connected with the side wall of the transmission rod (16) through a transmission shaft (45).
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| CN202110912184.9A CN113616316B (en) | 2021-08-10 | 2021-08-10 | Bladder tumor en-block whole cutting device based on electrotome |
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