CN114224445B - Device for establishing vascular tunnel under direct vision - Google Patents

Device for establishing vascular tunnel under direct vision Download PDF

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Publication number
CN114224445B
CN114224445B CN202111543572.0A CN202111543572A CN114224445B CN 114224445 B CN114224445 B CN 114224445B CN 202111543572 A CN202111543572 A CN 202111543572A CN 114224445 B CN114224445 B CN 114224445B
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China
Prior art keywords
vascular
subcutaneous
subcutaneous tunnel
inflation
tunnel device
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CN202111543572.0A
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CN114224445A (en
Inventor
杨晓虎
范隆华
郭振宇
王晨
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QINGPU BRANCH OF ZHONGSHAN HOSPITAL FUDAN UNIVERSITY
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QINGPU BRANCH OF ZHONGSHAN HOSPITAL FUDAN UNIVERSITY
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3478Endoscopic needles, e.g. for infusion
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3474Insufflating needles, e.g. Veress needles

Abstract

The utility model relates to a device for establishing a vascular tunnel under direct vision, which comprises a subcutaneous tunnel device, an inflation device and an electron microscope, wherein the inflation device is arranged on the subcutaneous tunnel device; the subcutaneous tunnel device body is of a cylindrical structure, and the front end of the subcutaneous tunnel device body is of a diameter gradually shrinking structure; the inside of the subcutaneous tunnel device is respectively provided with a hollow gas channel and a microscope channel; the inflation device comprises an inflation bag and an inflation tube; the diameter of the gas charging pipe is smaller than that of the gas channel; the electronic fiber mirror comprises a display screen and a fiber pipeline; the tail end of the fiber pipeline is connected with the display screen, and an internal lighting lamp and a camera at the front end of the fiber pipeline; the diameter of the fiber pipeline is smaller than that of the microscope pipeline. The advantages are as follows: when the vascular channel is established subcutaneously, the vascular tunneler can be directly pushed in the subcutaneous process, so that the vascular, nerve and muscle injuries are avoided, the pushing direction is convenient to adjust, the vascular anastomosis opening is accurately aligned, and the clinical complications are avoided.

Description

Device for establishing vascular tunnel under direct vision
Technical Field
The utility model relates to the technical field of medical equipment, in particular to a device for establishing a vascular tunnel under direct vision.
Background
The lower limb arteriosclerosis obliteration refers to a chronic progressive disease caused by the thickening of the intima, the lumen stenosis or the occlusion of the lower limb blood supply artery due to arteriosclerosis, and the disease is usually the manifestation of systemic arteriosclerosis vascular lesions in the lower limb artery.
Methods of treatment for lower extremity arteriosclerotic occlusive disease include surgical bypass surgery and endoluminal treatment. Although endoluminal treatment is the treatment of choice for lower extremity arteriosclerotic occlusive conditions with minimal trauma and minimal complications. However, tacii clearly indicates that a-shaped lesions are suitable for endoluminal treatment and D-shaped lesions recommend surgical treatment; meanwhile, the condition that the guide wire cannot pass through the occlusion section and other intracavitary treatments fail exists in the intracavitary treatments, so that the patient who fails in the intracavitary treatments and accords with the operation conditions can also consider to adopt the surgical treatment aiming at the case of the intracavitary treatments failure. At the same time, a great number of cases need to rely on the hybrid treatment of the operation of the endoluminal treatment and surgical bypass, so the current vascular bypass operation has wider therapeutic indications.
The femoral-femoral artery bypass, the femoral-popliteal artery bypass, the axillary-bifilar artery and the main-bifilar artery bypass are the main operation modes for the current surgical treatment of the arteriosclerosis obliterans of the lower limbs, and the connection between the inflow channel and the outflow channel is established through the artificial blood vessel or the autologous blood vessel, so that the treatment aim of relieving the ischemia of the lower limbs is achieved. The conventional subcutaneous tunnel is established by adopting a traditional subcutaneous vascular tunnel device, and the method has the following defects: (1) The method establishes a blood vessel channel subcutaneously according to experience of an operator, and can cause damage to blood vessels, nerves and muscles in the process of pushing the blood vessel tunneler subcutaneously because the blood vessel tunneler cannot be directly looked at, and especially in the process of main-double-strand bypass operation, the damage to iliofemoral vessels can be caused in the process of pushing the blood vessel tunneler subcutaneously, thereby causing fatal complications. (2) If the vascular injury causes the hypoabsorption of subcutaneous hematoma, serious complications such as further artificial vascular infection and the like can be caused; (3) Meanwhile, the subcutaneous tunnel device cannot be directly seen, and enters different anatomical layers in the pushing process, so that the damage (4) can be aggravated in the repeated pushing and withdrawing processes, and the pushing direction deviates from the position of a vascular anastomosis opening due to no visual fiber indication at the front end in the pushing process of the vascular tunnel device, so that the pushing reverse direction is required to be continuously adjusted, and the damage can be aggravated. Therefore, the development of a novel visual vascular tunneler can avoid the common clinical complications and reduce the operation difficulty and risk.
Chinese patent literature: CN202021563135.6, filing date 2020.07.31, patent name: a medical subcutaneous tunneler assembly. The utility model discloses a medical subcutaneous tunnel ware subassembly, this subassembly mainly comprises tunnel needle and corresponding length's tunnel ware, the tunnel needle is the joinable needle body, the front end of needle body is blunt syringe needle.
Chinese patent literature: CN202020148081.0, filing date 2020.01.30, patent name: a multi-functional subcutaneous tunnel device of light beam guide. The utility model discloses a multi-functional subcutaneous tunnel ware of light beam guide, concretely relates to medical instrument technical field, including the tunnel pole, the inboard grafting of tunnel pole has blunt light beam guide inner core, the inboard grafting of blunt light beam guide inner core has the optical cable, the medicine hole has all been seted up to the both sides of optical cable, the inboard of going out the medicine hole still peg graft and have sharp traction inner core.
The medical subcutaneous tunnel device component in the patent document CN202021563135.6 adopts a tunnel device as a cylinder, consists of an upper tunnel tube and a lower tunnel tube, and is connected with the connecting part in a clamping groove mode, so that the utility model can rapidly manufacture a subcutaneous tunnel with proper thickness, reduce excessive expansion caused by non-professional instruments, reduce the traction damage of blood vessels under the skin, ensure proper tightness, shorten operation time and relieve pain of patients; compared with the prior art, the multifunctional subcutaneous tunnel device with the light beam guidance in the patent document CN202020148081.0 is beneficial to accurately and easily establishing and guiding the subcutaneous tunnel for an operator in the operation of establishing the subcutaneous tunnel such as a intrathecal drug infusion channel and the like by arranging a tunnel rod, a blunt light beam guiding inner core, a light cable, a drug outlet hole, a sharp traction inner core, a connector, an adjusting head, an injector and a light source, thereby reducing pain and discomfort of the patient in the tunnel establishment process, increasing the satisfaction degree of the patient, improving the success rate of primary percutaneous tunnel traction, improving the operation efficiency and shortening the operation time. However, in the process of establishing a vascular channel subcutaneously, the vascular tunnel device can be directly advanced subcutaneously, so that the vascular, nerve and muscle injuries are avoided, the advancing direction is convenient to adjust, the vascular anastomosis is accurately aligned, and no related report exists at present on the establishment of the vascular tunnel device under a direct vision, which avoids clinical complications.
In view of the foregoing, there is a need for a direct vascular tunneler for subcutaneous vascular tunnel creation that can avoid vascular, nerve and muscle damage while simultaneously facilitating adjustment of the direction of advancement, precise alignment of the vascular anastomosis, and direct vision of the vascular tunneler during subcutaneous vascular tunnel creation, thereby avoiding clinical complications.
Disclosure of Invention
The utility model aims to overcome the defects of the prior art, and provides a device for establishing a blood vessel tunnel under direct vision, which can directly push a blood vessel tunnel device under the skin when the blood vessel channel is established under the skin, avoid damage to blood vessels, nerves and muscles, simultaneously facilitate adjustment of the pushing direction, accurately aim at a blood vessel anastomosis port and avoid clinical complications.
In order to achieve the above purpose, the technical scheme adopted by the utility model is as follows:
the device for establishing the vascular tunnel under the direct vision comprises a subcutaneous tunnel device, an inflation device and an electron microscope; the inside of the subcutaneous tunnel device is respectively provided with a hollow gas channel and a microscope channel; the inflation device comprises an inflation bag and an inflation tube; the diameter of the gas charging pipe is smaller than that of the gas channel; the electronic fiber mirror comprises a display screen and a fiber pipeline; the tail end of the fiber pipeline is connected with a display screen, and an illuminating lamp and a camera are arranged in the front end of the fiber pipeline; the diameter of the fiber pipeline is smaller than that of the microscope pipeline.
As a preferable technical scheme, the subcutaneous tunnel device body is of a cylindrical structure, and the front end of the subcutaneous tunnel device body is of a diameter gradually shrinking structure.
As a preferable technical scheme, the inflatable bag is of an electric inflatable structure.
As a preferable technical scheme, the subcutaneous tunnel device is internally provided with a blood vessel channel with a hollow structure.
The utility model has the advantages that:
1. through the design that subcutaneous tunnel ware body is cylindrical structure, the front end is the diameter gradually shrink structure, can reduce the resistance that subcutaneous tunnel ware got into in the subcutaneous fascia, conveniently impels or withdraws from.
2. Through be equipped with hollow structure's gas passage and microscope passageway respectively in subcutaneous tunnel ware inside, when the subcutaneous tunnel ware impels to subcutaneous fascia in, the accessible is put into gas passage with the inflation tube on the aerating device, is put into the microscope pipeline with the fibre pipeline on the electron microscope simultaneously.
3. The inflation tube is inflated through the inflation device in the operation, so that the gap between the subcutaneous fascia and the inflation tube is opened, the pushing of the subcutaneous tunnel device is facilitated, and meanwhile, the subcutaneous fascia tissue can be clearly displayed on the external display screen through the illumination lamp and the camera arranged inside the front end of the fiber pipeline by opening the electron microscope.
4. The operator can push the subcutaneous tunnel device in place under the direct vision state, and in the pushing process, the anatomical hierarchy, blood vessels, nerves and muscle tissues can be clearly distinguished, the important anatomical structures can be prevented from being damaged in the pushing process of the subcutaneous tunnel device, and complications of vascular, nerve and muscle damage of a patient are reduced.
5. After the subcutaneous tunnel device is pushed in place, the inflation tube and the microscopic tube can be withdrawn, and then the artificial blood vessel or the autologous blood vessel successfully passes through the subcutaneous tunnel through the channel in the subcutaneous tunnel device, so that the establishment of the vascular tunnel in a direct vision state is realized.
6. Through still being equipped with the design of vascular passageway in subcutaneous tunnel ware, can be after the subcutaneous tunnel ware impels to accurate position, can directly pass through vascular passageway with artificial blood vessel or autologous blood vessel and successfully get into subcutaneous tunnel, and need not to withdraw from gas tube and fibre pipeline earlier, be favorable to saving operation time.
Drawings
Fig. 1 is a schematic diagram of a subcutaneous tunnel device for establishing a vascular tunnel under direct view according to the present utility model.
Fig. 2 is a schematic structural view of an inflator and an electron microscope of the present utility model for establishing a vascular tunnel device under direct view.
Fig. 3 is a schematic diagram of the front end structure of a fiber pipeline of the device for establishing a vascular tunnel under direct view.
Fig. 4 is a schematic diagram of the overall structure of a device for establishing a vascular tunnel under direct view according to the present utility model.
Detailed Description
The utility model is further described below with reference to examples and with reference to the accompanying drawings.
Reference numerals and components referred to in the drawings are as follows:
1. subcutaneous tunnel 11. Gas passage
12. Microscope channel 2. Inflatable device
21. Inflatable bag 22. Inflatable tube
3. Electron microscope 3. Display screen
32. Fiber pipeline 33. Lighting lamp
34. Camera head
Example 1
Referring to fig. 1-3, fig. 1 is a schematic view of a subcutaneous tunnel device for establishing a vascular tunnel under direct view, fig. 2 is a schematic view of an inflation device and an electron microscope for establishing a vascular tunnel under direct view, and fig. 3 is a schematic view of a front end of a fiber tube for establishing a vascular tunnel under direct view. A device for establishing a vascular tunnel under direct vision, which comprises a subcutaneous tunnel device 1, an inflation device 2 and an electron microscope 3; the body of the subcutaneous tunnel device 1 is of a cylindrical structure, and the front end of the body is of a diameter gradually shrinking structure; the subcutaneous tunnel device 1 is internally provided with a hollow gas channel 11 and a microscope channel 12 respectively; the inflator 2 comprises an air bag 21 and an air tube 22; the diameter of the gas charging tube 22 is slightly smaller than that of the gas channel 11; the electronic fiberscope 3 comprises a display screen 31 and a fiber pipeline 32; the tail end of the fiber pipeline 32 is connected with the display screen 31, and a lighting lamp 33 and a camera 34 are arranged in the front end of the fiber pipeline 32; the diameter of the fiber tubing 32 is slightly smaller than the diameter of the microscope tubing 12.
It should be noted that: the body of the subcutaneous tunnel device 1 is of a cylindrical structure, the front end of the body is of a structure with gradually shrinking diameter, so that the resistance of the subcutaneous tunnel device 1 entering the subcutaneous fascia can be reduced, and the subcutaneous tunnel device is convenient to push or withdraw; the gas channel 11 and the microscope channel 12 with hollow structures are respectively arranged in the subcutaneous tunnel device 1, when the subcutaneous tunnel device is pushed into the subcutaneous fascia, the inflation tube 22 on the inflation device 2 can be arranged in the gas channel 11, and the fiber pipeline 32 on the electron microscope 3 can be arranged in the microscope pipeline 12; in the operation, the inflation tube 22 can be inflated through the inflation device 2, so that the gap between the deep and shallow fascia is opened, the pushing of the subcutaneous tunnel device 1 is facilitated, meanwhile, the subcutaneous fascia tissue can be clearly displayed on the external display screen 31 through the illumination lamp 33 and the camera 34 arranged in the front end of the fiber pipeline 32 by opening the electron microscope 3, so that an operator can conveniently push the subcutaneous tunnel device 1 in place under a direct vision state, in the pushing process, anatomical layers, blood vessels, nerves and muscle tissues can be clearly distinguished, important anatomical structures can be prevented from being damaged in the pushing process of the subcutaneous tunnel device 1, and complications of vascular, nerve and muscle injury of a patient can be reduced; after the subcutaneous tunnel device 1 is pushed in place, the inflation tube 22 and the micro-pipeline 32 can be withdrawn, and then the artificial blood vessel or the autologous blood vessel is successfully passed through the subcutaneous tunnel through the channel in the subcutaneous tunnel device 1, so that the establishment of the vascular tunnel in a direct vision state is realized.
Example 2
This embodiment is substantially the same as embodiment 1 except that a hollow vascular access (not shown) is further provided in the subcutaneous tunnel device 1 in this embodiment; the design of the blood vessel channel is further arranged in the subcutaneous tunnel device 1, so that after the subcutaneous tunnel device 1 is pushed to an accurate position, an artificial blood vessel or an autologous blood vessel can be directly and successfully introduced into the subcutaneous tunnel through the blood vessel channel, and the inflation tube 22 and the fiber pipeline 32 do not need to be withdrawn first, thereby being beneficial to saving the operation time.
According to the vascular tunnel device established under direct vision, the subcutaneous tunnel device body is of a cylindrical structure, and the front end of the vascular tunnel device is of a structure with gradually shrinking diameter, so that the resistance of the subcutaneous tunnel device entering the subcutaneous fascia can be reduced, and the vascular tunnel device is convenient to push or withdraw; through arranging the air channel and the microscope channel with hollow structures in the subcutaneous tunnel device respectively, when the subcutaneous tunnel device is pushed into the subcutaneous fascia, the air inflation tube on the air inflation device can be arranged in the air channel, and meanwhile, the fiber pipeline on the electron microscope can be arranged in the microscope pipeline; in the operation, the inflation tube can be inflated through the inflation device, so that the gap between the subcutaneous fascia is opened, the pushing of the subcutaneous tunnel device is facilitated, meanwhile, the subcutaneous fascia tissue can be clearly displayed on an external display screen through an illuminating lamp and a camera arranged in the front end of the fiber pipeline by opening an electron microscope, so that an operator can conveniently push the subcutaneous tunnel device in place under a direct vision state, in the pushing process, the anatomical hierarchy, blood vessels, nerves and muscle tissue can be clearly distinguished, important anatomical structures can be prevented from being damaged in the pushing process of the subcutaneous tunnel device, and complications of vascular, nerve and muscle injury of a patient can be reduced; after the subcutaneous tunnel device is pushed in place, the inflation tube and the microscopic pipeline can be withdrawn, and then the artificial blood vessel or the autologous blood vessel successfully passes through the subcutaneous tunnel through the channel in the subcutaneous tunnel device, so that the establishment of the vascular tunnel in a direct vision state is realized; through still being equipped with the design of vascular passageway in subcutaneous tunnel ware, can be after the subcutaneous tunnel ware impels to accurate position, can directly pass through vascular passageway with artificial blood vessel or autologous blood vessel and successfully get into subcutaneous tunnel, and need not to withdraw from gas tube and fibre pipeline earlier, be favorable to saving operation time.
The foregoing is merely a preferred embodiment of the present utility model and it should be noted that modifications and additions to the present utility model may be made by those skilled in the art without departing from the principles of the present utility model and such modifications and additions are to be considered as well as within the scope of the present utility model.

Claims (1)

1. The device for establishing the vascular tunnel under the direct vision is characterized by comprising a subcutaneous tunnel device, an inflation device and an electron microscope; the inside of the subcutaneous tunnel device is respectively provided with a hollow gas channel and a microscope channel; the inflation device comprises an inflation bag and an inflation tube, and the inflation tube is inflated through the inflation device, so that a deep-skin fascia gap is opened, and the subcutaneous tunnel device is convenient to push; the diameter of the gas charging pipe is smaller than that of the gas channel; the electron microscope comprises a display screen and a fiber pipeline; the tail end of the fiber pipeline is connected with a display screen, and an illuminating lamp and a camera are arranged in the front end of the fiber pipeline; the diameter of the fiber pipeline is smaller than that of the microscope pipeline, the subcutaneous tunnel device body is of a cylindrical structure, the front end of the subcutaneous tunnel device body is of a diameter gradually shrinking structure, the inflatable bag is of an electric inflatable structure, and a vascular channel of a hollow structure is further arranged in the subcutaneous tunnel device.
CN202111543572.0A 2021-12-16 2021-12-16 Device for establishing vascular tunnel under direct vision Active CN114224445B (en)

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Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5944732A (en) * 1997-08-27 1999-08-31 Medical Components, Inc. Subcutaneous tunnelling device and methods of forming a subcutaneous tunnel
WO2012030828A1 (en) * 2010-08-30 2012-03-08 C.R. Bard, Inc. Tunneler for bi-directional tunneling
CN104490430A (en) * 2015-01-05 2015-04-08 四川大学华西医院 Tunnel support for endoscopic submucosal dissection
CN108245204A (en) * 2018-01-18 2018-07-06 穆建成 A kind of subcutaneous space builder and its application method
CN208287029U (en) * 2017-08-02 2018-12-28 中国医学科学院北京协和医院 Hypodermic tunnel device
CN211534657U (en) * 2019-09-06 2020-09-22 江苏省人民医院(南京医科大学第一附属医院) Percutaneous nephroscope dilator capable of being directly viewed
CN213698477U (en) * 2020-04-17 2021-07-16 达州市中心医院 Central vein subcutaneous tunnel double-cavity catheter set

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090254095A1 (en) * 2008-03-18 2009-10-08 Blake Levine Subcutaneous tunneling device

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5944732A (en) * 1997-08-27 1999-08-31 Medical Components, Inc. Subcutaneous tunnelling device and methods of forming a subcutaneous tunnel
WO2012030828A1 (en) * 2010-08-30 2012-03-08 C.R. Bard, Inc. Tunneler for bi-directional tunneling
CN104490430A (en) * 2015-01-05 2015-04-08 四川大学华西医院 Tunnel support for endoscopic submucosal dissection
CN208287029U (en) * 2017-08-02 2018-12-28 中国医学科学院北京协和医院 Hypodermic tunnel device
CN108245204A (en) * 2018-01-18 2018-07-06 穆建成 A kind of subcutaneous space builder and its application method
CN211534657U (en) * 2019-09-06 2020-09-22 江苏省人民医院(南京医科大学第一附属医院) Percutaneous nephroscope dilator capable of being directly viewed
CN213698477U (en) * 2020-04-17 2021-07-16 达州市中心医院 Central vein subcutaneous tunnel double-cavity catheter set

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