CN113616316B - Bladder tumor en-block whole cutting device based on electrotome - Google Patents
Bladder tumor en-block whole cutting device based on electrotome Download PDFInfo
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- CN113616316B CN113616316B CN202110912184.9A CN202110912184A CN113616316B CN 113616316 B CN113616316 B CN 113616316B CN 202110912184 A CN202110912184 A CN 202110912184A CN 113616316 B CN113616316 B CN 113616316B
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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 an electronic cutting mirror-based bladder tumor en-block whole cutting device, which relates to the technical field of medical appliances 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 en-block whole cutting device for the electrotome bladder tumor can inject physiological saline into the bladder through the water quantity adjusting device, so that the bladder filling degree can be maintained for a long time under the condition of not affecting the visual field; meanwhile, the device realizes tumor traction 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 resected tissue can be realized.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to an electrotome-based bladder tumor en-block whole excision device.
Background
Bladder tumors have a high incidence, with 75% of new bladder malignancies being non-myogenic invasive bladder cancers (non-muscle invasive bladder cancer, NMIBC). For NMIBC, transurethral bladder tumor (plasma) electrotomy is the most common treatment modality. Whereas the efficacy of NMIBC treatment and prognosis of the patient are directly determined by the urinary bladder tumor (plasma) electrotomy. At present, a clinical NMIBC electrotomy method is usually adopted, but the slicing excision is easy to cause tumor residues, an fulgurating tumor tissue causes eschar to form an illegible layer, the integrity of a tissue structure is destroyed, and the biopsy of the minced tissue easily causes missed diagnosis and stage deviation of a pathology on highly malignant tumor components. The literature reports that after NMIBC electrotomy, considerable tumor recurrence is caused by tumor residues, especially medium and high grade T1 bladder cancer, the tumor residual rate can reach 33.8% -36%, and in addition, due to the quality problems of electrotomy technology and the tumor specimens to be sent for the first time, pathological stage deviations of a part of tumors can be caused.
In order to solve the problems, the current medical field mainly adopts an en-block whole excision method to replace the traditional fragmented excision, and the method can completely excision the bladder tumor and the bladder mucosa and muscular layer of the area where the tumor is located, so that the purpose of fully preserving the complete tissue structure and the substrate is achieved, the tumor recurrence rate is well reduced, and the correctness of pathological diagnosis of the tumor is improved. However, there is currently no medical instrument specifically for en-block excision of bladder tumors. The use of laser ablation and conventional resectoscope for en-block ablation of bladder tumors is currently two major methods. However, the use of laser requires additional purchase of laser equipment and related consumables, increasing cost; subcutaneous water injection is needed in the operation in advance, so that the operation procedure is complicated and the operation time is prolonged; and it is difficult to treat multiple (> 5) tumors, especially those that grow creeping. While the conventional resectoscope is used for performing the en-block excision of the bladder tumor, although the new purchase equipment and the increase of consumable materials in the operation are not needed, and multiple and polymorphic tumors can be treated in a mode of combining the en-block excision and the conventional slicing excision, the conventional resectoscope is difficult to obtain proper tension for the tumor to realize accurate layer separation when performing the en-block excision of the bladder tumor, and is difficult to maintain proper filling degree of the bladder for a long time so as to avoid influencing the visual field due to frequent water drainage or water regulation, and the target pathological tissue is accurately cut and accurately collected in real time so as to avoid the 3 main problems that the target cutting tissue is mixed into other cutting tissue fragments.
In order to enable the existing transurethral resection device to be better applied to endlock resection of bladder tumors, the invention creatively improves the existing transurethral resection device, so that the existing transurethral resection device can realize traction of tumors, continuously manufacture adjustable tension, simultaneously maintain bladder fullness for a long time without influencing visual field, and simultaneously realize real-time collection of target resected tissues. Enabling the surgeon to better perform the bladder tumor en-block excision procedure.
Disclosure of Invention
The invention aims to provide an electrotome-based bladder tumor en-block whole excision device, which can inject physiological saline into a bladder while cutting tumors, can regulate and control the water injection amount in the bladder, keeps the stable filling state of the bladder, and is convenient for ensuring that a clear view is provided when cutting tumors; simultaneously, the device easy operation is convenient, and can absorb the collection to the tumour fragment after the tumour cutting.
The technical aim of the invention is realized by the following technical scheme: an electrotome-based bladder tumor en-block whole excision device 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 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, which is far away from the control box body; the observation device comprises an ocular, a focusing device, a lens cone and an endoscope; one end of the lens barrel is connected with the control box body, one end of the lens barrel, 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 barrel, is connected with the ocular; one end of the endoscope is positioned in the control box body, the endoscope is connected with the lens barrel, and one end of the endoscope, which is far away from the control box body, passes 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 outer sheath and is communicated with the outside of the tumor cutting device, the other end of the water inlet pipe penetrates through the control box body and is communicated with the outside of the tumor cutting 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, the side wall of the annular collecting bin is provided with a liquid inlet communicated with the outside of the tumor resection device, 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 quantity in the bladder can be controlled by adjusting the water quantity adjusting device, so that the visual field effect of the electric cutting 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 inside the bladder through the ocular; by adjusting the focusing means, the sharpness presented by the eyepiece can be adjusted according to different circumstances.
The invention is further provided with: the separation device comprises an L-shaped sliding plate, a handle, a filter screen and a tumor mass 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 the two opposite side walls of the tumor mass storage, and the filter screen is positioned at the end part of the water outlet pipe, which is close to the water outlet end of the tumor mass storage; the opposite side walls of the tumor mass storage are provided with two U-shaped sliding grooves, the horizontal section of the L-shaped sliding plate is positioned in the U-shaped sliding grooves, the outer side wall of the vertical section of the L-shaped sliding plate is flush with the outer side wall of the tumor mass storage, and the handle is fixedly connected with the outer side wall of the vertical section of the L-shaped sliding plate.
By adopting the technical scheme, the water outlet pipe penetrates through two opposite side walls of the tumor mass storage, and the filter screen is arranged at the end part of the water outlet pipe, which is close to the water outlet end of the tumor mass storage, so that physiological saline and tumor fragments entering the tumor mass storage from the water outlet pipe can be separated at the filter screen; by installing the L-shaped sliding plate at the bottom of the tumor mass storage device, tumor fragments can be collected and conveniently taken out.
The invention is further provided with: 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 chute, a first roller is arranged in the first chute, the 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 positioned at 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 pressing device and insulating piece, and the connecting rod is connected with the insulating piece through ejector pin one, can control whole electrically controlled device's switch through pressing device to the circular telegram condition of control electricity cutting ring.
The invention is further provided with: the pressing device comprises a pressing handle, a hollow handle, a connecting block, an arc-shaped sliding block, an inclined block and a top block, wherein the pressing handle is hinged with the hollow handle, 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 handle; the side wall of arc slider touches with oblique piece, the tip that the connecting block was kept away from to the arc slider touches with the bottom of kicking block, the inside wall fixed connection of lateral wall and the cavity handle of sloping block, the lateral wall and the inside wall swing joint of cavity handle of kicking block, the bottom fixed connection of top and insulating block of kicking 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 electric control unit switch on through pressing the press handle to the effect of manual control electricity cutting ring switch on has been realized.
The invention is further provided with: a tumor supporting device is arranged in the control box body, the tumor supporting device comprises a control device and a swinging device, and the control device comprises a knob, a rotating rod, a gear, a transmission rod and a limiting block; the knob is contacted with the outer side wall of the control box body, the rotating shaft of the knob is connected with the 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 positioned in the control box body, the end part of the transmission rod, which is far away from the control box body, penetrates through the limiting block and is 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 pendulous device luffing motion for pendulous device jack-up tumor reaches the effect of being convenient for to the tumor cutting.
The invention is further provided with: the swinging device comprises a second ejector rod and a transmission shaft; the side wall of the outer sheath, which is close to the second ejector rod, is provided with a swinging groove, the second ejector rod penetrates through the swinging groove and is hinged with the side wall of the outer sheath, the side wall of the second ejector rod is provided with a second sliding groove, the second roller is positioned in the second sliding groove, and the 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 through the knob and reciprocate, the transfer line drives gyro wheel two and removes in spout two to realize ejector pin two and swing in the swinging tank, ejector pin two can jack up the tumour, reaches the effect that makes things convenient for medical personnel to cut the root of tumour.
In summary, the invention has the following beneficial effects:
1. by arranging the water quantity adjusting device in the control box body, 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 electric cutting 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 inside the bladder through the ocular; the definition presented by the ocular can be adjusted according to different conditions by adjusting the focusing device;
3. through the tumor supporting device, the tumor is convenient to be jacked up or pulled to a proper position for fixation by manufacturing tension, and the cutting operation of the tumor is convenient.
Drawings
FIG. 1 is a schematic structural view of an electrotome-based bladder tumor en-block whole excision device in an 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 in fig. 1;
fig. 5 is an enlarged view of D in fig. 1;
FIG. 6 is a schematic structural view of a swing device of an electrotome-based bladder tumor en-block whole excision device according to an 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 swinging groove; 19. a second ejector rod; 20. an electric cutting ring; 21. an annular collection bin; 22. a liquid inlet; 23. an electric control box body; 24. connecting a guide rod; 25. a first chute; 26. a roller I; 27. an insulating block; 28. a top block; 29. a first ejector rod; 30. a power cord jack; 31. a transformer; 32. a switch contact; 33. a rotating shaft; 34. a connecting block; 35. an arc-shaped sliding block; 36. a sloping block; 37. tumor mass storage; 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 transmission shaft; 46. and (5) rotating the rod.
Detailed Description
The invention is described in further detail below with reference to fig. 1-6.
Examples: the utility model provides a cutting mirror-based bladder tumor en-block monoblock cutting device, as shown in figures 1 to 6, 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 hollow cylinders, and the outer sheath 15 is sheathed 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 includes 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 far away from the control box body 12 is fixedly connected with the focusing device 10, and one end of the adjusting device far away from the lens barrel 11 is fixedly connected with the ocular 9; one end of the endoscope 1 is positioned in the control box body 12, the endoscope 1 is fixedly connected with the lens barrel 11, and one end of the endoscope 1, which is far away from the control box body 12, passes through the end parts of the inner sheath 2 and the outer sheath 15 and is 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 the outer sheath 15 to be communicated with the outside of the tumor cutting device, the other end of the water inlet pipe 6 penetrates through the control box 12 to be communicated with the outside of the tumor cutting 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 arranged on 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 passes 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 present embodiment, when a medical staff is in the bladder during the process of cutting a bladder tumor, the endoscope 1 transmits a visual field into the lens barrel 11, and when the visual field is transmitted into the ocular lens 9 through the endoscope 1 by the focusing device 10, the medical staff observes the situation in the bladder by the ocular lens 9; during the observation process, medical staff can control the definition by adjusting the focusing device 10, and finally cut the bladder tumor through the resectoscope; when observing the internal condition of the bladder, if the visual field in the bladder is not good enough, medical staff can adjust the water inlet regulating valve 7 to increase the water inlet flow, and simultaneously adjust the water outlet regulating 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 physiological saline and then enter the separation device, the tumor fragments remain in the separation device, and the physiological saline is discharged to the outside of the tumor cutting device from the water outlet pipe 14; in this embodiment, the outer sheath is hollow cylindrical and the outer sheath is 20Fr-22Fr in size, which is shaped and sized to allow the device to pass through the urethra into the bladder.
The separating device comprises an L-shaped slide plate 41, a handle 38, a filter screen 40 and a tumor mass reservoir 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 the 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, which is close to the water outlet end of the tumor mass storage 37; two U-shaped sliding grooves 39 are formed in the opposite side walls of the tumor mass storage 37, the horizontal section of the L-shaped sliding plate 41 is located in the U-shaped sliding grooves 39, the outer side wall of the vertical section of the L-shaped sliding plate 41 is flush with the outer side wall of the tumor mass storage 37, and the handle 38 is fixedly connected with the outer side wall of the vertical section of the L-shaped sliding plate 41.
In this embodiment, the tumor fragments and the physiological saline enter the tumor mass storage 37 at the same time, the filter screen 40 filters the tumor fragments due to the effect of the filter screen 40, the tumor fragments finally fall on the bottom of the L-shaped slide plate 41, after the tumor is cut, the medical staff can pull the handle 38 to take out the L-shaped slide plate 41, pour the tumor mass, and insert the L-shaped slide plate 41 into the tumor mass storage 37; in this embodiment, the L-shaped slide 41 slides along the U-shaped chute 39, which is sealed when the outer side wall of the vertical section of the L-shaped slide 41 is flush with the outer side wall of the control housing 12.
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 passes 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 passes 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 chute 25, the first chute 25 is connected with a first roller 26 in a sliding way, 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 cabinet 23, the bottom of the transformer 31 is connected with the power line socket 30, the power line socket 30 is positioned on the outer side of the electric cabinet 23, and the output end of the transformer 31 is connected with the switch contact 32.
In this embodiment, in the process of cutting a tumor, when the electric cutting ring 20 is close to the bottom of the tumor, the top block 28 moves upwards along the hollow handle 5, the top block 28 drives the insulating block 27 to move upwards, the insulating block 27 drives the first push rod 29 to move upwards, the first push rod 29 moves upwards in the process of moving upwards, the first roller 26 slides in the first 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 electric cutting ring 20, the electric cutting ring 20 is electrified to cut the tumor in the bladder, and after the tumor is cut off, the top 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 electric cutting ring 20 is not electrified.
The pressing device comprises a pressing handle 4, a hollow grip 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 grip 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 grip 5; the side wall of the arc-shaped sliding block 35 is contacted with the inclined block 36, the end part of the arc-shaped sliding block 35 away from the connecting block 34 is contacted with the bottom of the top block 28, the side wall of the inclined block 36 is fixedly connected with the inner side wall of the hollow handle 5, the outer side wall of the top block 28 is movably connected with the inner side wall of the hollow handle 5, and the top of the top block 28 is fixedly connected with the bottom of the insulating block 27.
In this embodiment, when the electric cutting ring 20 is located at the root of a tumor, the medical staff presses the pressing handle 4, the pressing handle 4 drives the connecting block 34 to move towards the hollow grip 5, the hollow grip 5 drives the arc-shaped slide block 35 to move along the inclined plane of the inclined block 36, and the end of the arc-shaped slide block 35 pushes up the top block 28, so that the top block 28 moves upwards along the hollow grip 5, and the connection guide rod 24 is connected with the switch contact 32, so that the electric cutting ring 20 is electrified.
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 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 passes 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 cutting a tumor, the end of the second ejector rod 19 is located at the tumor, at this time, the medical staff rotates the knob 13, the rotary knob 13 drives the gear 42 to rotate through the rotary rod 46, the gear 42 drives the transmission rod 16 to move rightward along the horizontal direction, and the limiting block 17 is fixed on the inner side wall of the outer sheath 15, so that the transmission rod 16 only reciprocates horizontally, thereby swinging the swinging device.
The swinging device comprises a second ejector rod 19 and a transmission shaft 45; the side wall of the outer sheath 15, which is close to the second ejector rod 19, is provided with a swinging groove 18, the second ejector rod 19 passes through the swinging 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 chute 43, a second roller 44 is positioned in the second chute 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 roller two 44 to roll in the chute two 43 through the transmission shaft 45, the effect of swinging the ejector rod two 19 up and down can be achieved because one end of the ejector rod two 19 is hinged with the inner side wall of the outer sheath 15.
Working principle: 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 electric cutting 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 12, the operator can observe the state inside the bladder through the eyepiece 9; by adjusting the focusing means 10, the sharpness presented by the eyepiece 9 can be adjusted according to different situations.
The present embodiment is only for explanation of the present invention and is not to be construed as limiting the present invention, and modifications to the present embodiment, which may not creatively contribute to the present invention as required by those skilled in the art after reading the present specification, are all protected by patent laws within the scope of claims of the present invention.
Claims (5)
1. The utility model provides a cutting mirror bladder tumor en-block monoblock excision device based on, 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 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 ocular lens (9), a focusing device (10), a lens cone (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 ocular lens (9); one end of the endoscope (1) is positioned in the control box body (12), the endoscope (1) is connected with the lens barrel (11), and one end of the endoscope (1) far away from the control box body (12) passes through the end parts of the inner sheath (2) and the outer sheath (15) and is 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 the outer sheath (15) to be communicated with the outside of the tumor cutting 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 cutting 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);
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 the 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 opposite side walls of the tumor mass storage (37) are provided with two U-shaped sliding grooves (39), the horizontal section of the L-shaped sliding plate (41) is positioned in the U-shaped sliding grooves (39), the outer side wall of the vertical section of the L-shaped sliding plate (41) is flush with the outer side wall of the tumor mass storage (37), and the handle (38) is fixedly connected with the outer side wall of the vertical section of the L-shaped sliding plate (41).
2. The resectoscope-based bladder tumor en-block whole-block resecting device of claim 1, wherein the resecting device comprises: 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, far away from the control box body (12), of the outer sheath (15) and is connected with the electric cutting ring (20); the side wall of the connecting guide rod (24) is provided with a first chute (25), a first roller (26) is arranged in the first chute (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 cabinet body (23), the bottom of the transformer (31) is connected with the power line socket (30), the power line socket (30) is positioned on the outer side of the electric cabinet body (23), and the output end of the transformer (31) is connected with the switch contact (32).
3. The resectoscope-based bladder tumor en-block whole-block resecting device of claim 2, wherein: the pressing device comprises a pressing handle (4), a hollow grip (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 grip (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 grip (5); the side wall of arc slider (35) and sloping block (36) contact, the tip that connecting block (34) was kept away from to arc slider (35) contacts with the bottom of kicking block (28), the lateral wall of sloping block (36) and the inside wall fixed connection of cavity handle (5), the lateral wall of kicking block (28) and the inside wall swing joint of cavity handle (5), the bottom fixed connection of top and insulating block (27) of kicking block (28).
4. The resectoscope-based bladder tumor en-block whole-block resecting device of claim 1, wherein the resecting device comprises: 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 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).
5. The resectoscope-based bladder tumor en-block whole-block resecting device of claim 4, wherein the resecting device comprises: the swinging device comprises a second ejector rod (19), a second roller (44) and a transmission shaft (45); the outer sheath (15) is close to the lateral wall of the ejector rod II (19) and is provided with a swinging groove (18), the ejector rod II (19) penetrates through the swinging groove (18) and is hinged to the lateral wall of the outer sheath (15), the lateral wall of the ejector rod II (19) is provided with a sliding groove II (43), a roller II (44) is located in the sliding groove II (43), and a rotating shaft (33) of the roller II (44) is fixedly connected with the lateral 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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