CN114469266B

CN114469266B - Metal clamp dental floss integrated traction forceps and method for assisting endoscopic submucosal stripping

Info

Publication number: CN114469266B
Application number: CN202210093384.0A
Authority: CN
Inventors: 高飞; 王建铭; 韩杰
Original assignee: General Hospital of Shenyang Military Region
Current assignee: General Hospital of Shenyang Military Region
Priority date: 2022-01-26
Filing date: 2022-01-26
Publication date: 2023-07-07
Anticipated expiration: 2042-01-26
Also published as: CN114469266A

Abstract

A metal clip dental floss integrated traction forceps for assisting in endoscopic submucosal stripping and a method thereof belong to the field of medical appliances, the traction forceps comprise a controller I, a guide wire I, a metal clip I, a controller II, a guide wire II, a metal clip II, a sheath tube and dental floss, wherein the controller I is connected with a control end of the metal clip I through the guide wire I, the controller II is connected with a control end of the metal clip II through the guide wire II, the guide wire I and the guide wire II are sleeved with the sheath tube together, and two ends of the dental floss are respectively connected with the clamp tubes of the metal clip I and the metal clip II; the using method comprises preparation, access, clamping and traction fixation. According to the metal dental floss clamping integrated traction forceps and the method, the dental floss is clamped in advance by using the double-head forceps to synchronously enter, traction can be completed at one time under an endoscope, operation is simple and quick, safety and reliability are realized, operation efficiency is greatly improved, misoperation is effectively prevented, the number of sheath tubes is reduced, and production cost is saved.

Description

Metal clamp dental floss integrated traction forceps and method for assisting endoscopic submucosal stripping

Technical Field

The invention belongs to the field of medical appliances, and particularly relates to a metal dental floss clamping integrated traction forceps and a method for assisting submucosal stripping of an endoscope.

Background

Endoscopic Submucosal Dissection (ESD) is an advanced endoscopic surgery, and performs minimally invasive bulk excision on a large focus, so that the method has the advantages of definite curative effect, small wound, quick recovery, capability of obtaining complete and accurate pathological diagnosis and the like, and has become an effective means for treating gastrointestinal canceration. However, the submucosal field of view is poor, and it is difficult to rapidly, accurately and safely perform focal resection, so that the operation time is long and the operation efficiency is low. Therefore, the mucosa is required to be pulled by an auxiliary technology, so that the peeling layer is effectively exposed to the field of view in the ESD operation, and the accurate and safe focus peeling is convenient.

At present, metal clip dental floss combined traction is an auxiliary technology for endoscopic submucosal stripping, and is formed by combining 2 metal clips and 1 dental floss under endoscopic operation, specifically, the operation is that threads are firstly tied between two side clip arms of a first metal clip in vitro, the metal clips are fixedly clamped on a focus with cut edges through an endoscopic biopsy channel, and then a second metal clip is fixed on opposite side mucous membrane together with the other end of the dental floss through the endoscopic biopsy channel again, so that stripping tissues generate tension from opposite sides, and traction is obtained. The traction device is mainly applied to traction of endoscopic submucosal dissection in difficult treatment places, and better exposes submucosal vision. Single clamp reference publication number CN209422007U patent name an endoscopic mucosal traction clamp.

However, the existing metal clip dental floss combined traction technology needs to be sent into the metal clip through the endoscope biopsy channel for many times, which takes a long time, and when the second metal clip clamps dental floss, the second metal clip is relatively difficult, even causes repeated operation, and the mucosa is damaged due to improper operation.

Disclosure of Invention

Aiming at the problems that two single clamps are difficult to operate, long in time consumption, easy to cause repeated operation, damage to mucous membrane and the like in the prior art, the invention provides the metal dental floss clamping integrated traction clamp and the method for assisting in peeling under mucous membrane of an endoscope. The specific technical scheme is as follows:

an integrated traction forceps for metal clamp dental floss for assisting in endoscopic submucosal stripping comprises a controller I1, a guide wire I2, a metal clamp I3, a controller II 4, a guide wire II 5, a metal clamp II 6, a sheath tube 7 and dental floss 8;

the controller I1 is connected with the control end of the metal clamp I3 through a guide wire I2; the controller II 4 is connected with the control end of the metal clamp II 6 through a guide wire II 5; the guide wire I2 and the guide wire II 5 are sleeved with a sheath tube 7; two ends of the dental floss 8 are respectively connected with clamp pipes of a metal clamp I3 and a metal clamp II 6;

in the technical scheme, the controller I1 comprises an operating rod I1.1, an operating handle thumb button I1.2, a sliding sleeve I1.3 and a pull ring I1.4; the thumb button I1.2 of the operating handle is arranged at the rear end of the operating rod I1.1, the operating rod I1.1 is sleeved with a sliding sleeve I1.3, and pull rings I1.4 are arranged on two sides of the sliding sleeve I1.3;

in the technical scheme, the controller I1 controls the expansion and closing of the metal clamp I3 through the guide wire I2; the sliding sleeve I1.3 slides along the operating rod I1.1 to control the metal clip I3 to shrink in the port of the sheath tube 7 or extend out of the port of the sheath tube 7; the thumb buckle I1.2 of the operating handle is used for fixing the operating rod I1.1, and the pull ring I1.4 is used for controlling the sliding sleeve I1.3 to slide;

in the technical scheme, the controller II 4 comprises an operating rod II 4.1, an operating handle thumb button II 4.2, a sliding sleeve II 4.3 and a pull ring II 4.4; the thumb button II 4.2 of the operating handle is arranged at the rear end of the operating rod II 4.1, the operating rod II 4.1 is sleeved with a sliding sleeve II 4.3, and pull rings II 4.4 are arranged on two sides of the sliding sleeve II 4.3;

in the technical scheme, the controller II 4 controls the expansion and closing of the metal clamp II 6 through the guide wire II 5; the sliding sleeve II 4.3 slides along the operating rod II 4.1 to control the metal clip II 6 to shrink in the port of the sheath tube 7 or extend out of the port of the sheath tube 7; the operating handle thumb button II 4.2 is used for fixing an operating rod II 4.1, and the pull ring II 4.4 is used for controlling the sliding sleeve II 4.3 to slide;

in the technical scheme, the guide wire I2 is connected or released to be separated from the metal clamp I3; the guide wire II 5 is connected with or released from the metal clip II 6;

in the technical scheme, when the traction forceps enter the gastrointestinal tract, the metal clamp I3, the metal clamp II 6 and the dental floss 8 are positioned in the port of the sheath tube 7; when the traction forceps work and clamp, the metal clamp I3, the metal clamp II 6 and the dental floss 8 are positioned outside the port of the sheath tube 7;

in the technical scheme, the length of the dental floss 8 is 1-3 cm;

in the technical scheme, the distance between the metal clamp II 6 and the metal clamp I3 is 1-3 cm;

the application method of the metal dental floss clamping integrated traction forceps for assisting the submucosal stripping of the endoscope comprises the following steps of;

step 1, preparation:

two ends of the dental floss 8 are respectively connected with clamp pipes of the metal clamp I3 and the metal clamp II 6, and the controller I1 and the controller II 4 are operated to enable the metal clamp I3 and the metal clamp II 6 to be positioned inside the port of the sheath pipe 7 together with the dental floss 8;

step 2, entering:

extending the sheath tube 7 to the focus through the endoscope biopsy pore canal;

step 3, clamping:

operating the controller I1 to enable the metal clamp I3 to extend out of the sheath tube 7 and clamp on the focus with the cut edge, and then releasing the guide wire I2 to separate from the metal clamp I3;

step 4, traction fixation:

the controller II 4 is operated to enable the metal clip II 6 to extend out of the sheath tube 7 and be clamped on mucous membrane on the opposite side of the focus, at this time, the metal clip II 6 pulls the metal clip I3 through the dental floss 8, and then the focus is pulled, so that the stripping layer surface is effectively exposed to the field of view in ESD operation.

Compared with the prior art, the metal dental floss clamping integrated traction forceps and the method for assisting the submucosal stripping of the endoscope have the beneficial effects that:

1. the two metal clamps of the traction forceps are respectively connected with two ends of dental floss, are simultaneously retracted into the sheath tube, are fixedly clamped on a focus at the cut edge after entering the field of view of an endoscopic operation, and then are fixedly clamped on opposite side mucous membranes, and the dental floss is connected with the two metal clamps in advance, so that the falling-off of the dental floss and the operation of simultaneously clamping the dental floss and the opposite side mucous membranes of lesions when the second metal clamp clamps the dental floss are avoided, the complexity of the traction operation is greatly reduced, the safety is improved, the misoperation is effectively prevented, and the mucous membranes are damaged.

2. According to the traction forceps, the sheath tube is conveyed into an endoscopic surgery area through the endoscopic biopsy pore canal according to the requirements in the surgery, the sheath tube does not need to repeatedly enter the endoscopic biopsy pore canal, the disposable traction operation in the cavity is realized, and the surgery speed is shortened by at least half.

The traction forceps in the prior art need to enter the endoscope biopsy channel at least twice, and carry out secondary clamping of dental floss in the gastrointestinal tract, so that the operation level of doctors is very tested, and the operation speed is directly influenced.

3. The traction forceps disclosed by the invention have the advantages that two guide wires are designed in the same sheath tube, so that two metal clamps can reach a focus smoothly at the same time, and one sheath tube enters to effectively reduce damage or discomfort.

4. The two metal clips are arranged in the sheath tube in a staggered manner, but not arranged side by side, so that the diameter size of the sheath tube can be reduced; in addition, the dislocation setting can be better pull the gauge beam dental floss, prevents that the dental floss from taking place to knot or drifting the wire winding.

5. The dental floss is connected to the clamp pipe of the metal clamp, so that the connection is more reliable and firm, and the dental floss does not fall off. The dental floss in the prior art is sleeved on the clamping teeth of the metal clamp, and is easy to fall off during operation.

6. The dental floss is connected to the clamp pipe of the metal clamp, can not be strung during operation traction, is more tensioned during traction, and has better operation vision. However, the dental floss in the prior art is sleeved on the clamping teeth, so that the dental floss can slide along the clamping teeth during operation traction, and the traction effect is poor.

7. The traction forceps have the advantages of simple use method, safety and reliability for patients, improvement of surgical cutting precision and good practical value.

In conclusion, the traction forceps can improve the operation efficiency, is simple and convenient to traction, saves the time of multiple times of metal clips entering the endoscope biopsy channel, reduces the operation difficulty, greatly shortens the time of the whole operation, has wide application range, reduces the number of sheath tubes compared with the existing two single forceps, and saves the production cost.

Drawings

FIG. 1 is a schematic view of a metal-clip floss integrated pulling clamp for assisting submucosal dissection of an endoscope according to an embodiment of the present invention;

FIG. 2 is a schematic view of the working state of a metal clip I of an integrated metal clip dental floss pulling forceps for assisting submucosal dissection of an endoscope according to an embodiment of the invention;

in the figure, the controller I, the 1.1-operating rod I, the 1.2-operating handle thumb button I, the 1.3-sliding sleeve I, the 1.4-pull ring I, the 2-guide wire I, the 3-metal clip I, the 4-controller II, the 4.1-operating rod II, the 4.2-operating handle thumb button II, the 4.3-sliding sleeve II, the 4.4-pull ring II, the 5-guide wire II, the 6-metal clip II, the 7-sheath tube and the 8-dental floss are shown.

Detailed Description

The invention will be further described with reference to specific embodiments and figures 1-2, but the invention is not limited to these embodiments.

Example 1

An integrated traction forceps for metal clip dental floss for assisting endoscopic submucosal dissection, as shown in fig. 1-2, the traction forceps comprises a controller I1, a guide wire I2, a metal clip I3, a controller II 4, a guide wire II 5, a metal clip II 6, a sheath tube 7 and dental floss 8;

the controller I1 is connected with the control end of the metal clamp I3 through a guide wire I2; the controller II 4 is connected with the control end of the metal clamp II 6 through a guide wire II 5; the guide wire I2 and the guide wire II 5 are sleeved with a sheath tube 7; two ends of the dental floss 8 are respectively connected with clamp pipes of the metal clamp I3 and the metal clamp II 6;

the controller I1 comprises an operating rod I1.1, an operating handle thumb button I1.2, a sliding sleeve I1.3 and a pull ring I1.4; the thumb button I1.2 of the operating handle is arranged at the rear end of the operating rod I1.1, the operating rod I1.1 is sleeved with a sliding sleeve I1.3, and pull rings I1.4 are arranged on two sides of the sliding sleeve I1.3;

the controller I1 controls the expansion and closing of the metal clamp I3 through the guide wire I2; the sliding sleeve I1.3 slides along the operating rod I1.1 to control the metal clip I3 to shrink in the port of the sheath tube 7 or extend out of the port of the sheath tube 7; the thumb button I1.2 of the operating handle is used for fixing the operating rod I1.1, and the pull ring I1.4 is used for controlling the sliding sleeve I1.3 to slide;

the controller II 4 comprises an operating rod II 4.1, an operating handle thumb button II 4.2, a sliding sleeve II 4.3 and a pull ring II 4.4; the thumb button II 4.2 of the operating handle is arranged at the rear end of the operating rod II 4.1, the operating rod II 4.1 is sleeved with a sliding sleeve II 4.3, and pull rings II 4.4 are arranged on two sides of the sliding sleeve II 4.3;

the controller II 4 controls the expansion and closing of the metal clamp II 6 through the guide wire II 5; the sliding sleeve II 4.3 slides along the operating rod II 4.1 to control the metal clip II 6 to shrink in the port of the sheath tube 7 or extend out of the port of the sheath tube 7; the thumb button II 4.2 of the operating handle is used for fixing the operating rod II 4.1, and the pull ring II 4.4 is used for controlling the sliding sleeve II 4.3 to slide;

the guide wire I2 is connected with or released from the metal clamp I3; the guide wire II 5 is connected with or released from the metal clip II 6;

when the traction forceps enter the gastrointestinal tract, the metal clamp I3, the metal clamp II 6 and the dental floss 8 are positioned in the port of the sheath tube 7; when the traction forceps work and clamp, the metal clamp I3, the metal clamp II 6 and the dental floss 8 are positioned outside the port of the sheath tube 7;

the length of the dental floss 8 of this embodiment is 3cm; the distance between the metal clamp II 6 and the metal clamp I3 is 3cm;

step 1, preparation:

step 2, entering:

step 3, clamping:

step 4, traction fixation:

The comparative experiment shows that the traction pliers in the prior art have longer time consumption in traction operation; the operation time of the traction forceps in the embodiment is relatively shortened after trial, and the operation time is effectively saved in the whole process.

Example 2

the length of the dental floss 8 of this embodiment is 2cm; the distance between the metal clamp II 6 and the metal clamp I3 is 2cm;

step 1, preparation:

step 2, entering:

step 3, clamping:

step 4, traction fixation:

Through comparison and trial, the traction pliers in the prior art have complicated operation and error phenomenon, and cause repeated operation; the traction pliers of the embodiment have smooth use process and no error phenomenon.

Example 3

the length of the dental floss 8 of this embodiment is 1cm; the distance between the metal clamp II 6 and the metal clamp I3 is 1cm;

step 1, preparation:

step 2, entering:

step 3, clamping:

step 4, traction fixation:

Through trial, the traction forceps of the embodiment are safe and reliable to use, the dental floss traction effect is better, the falling phenomenon during traction operation can not occur, and the surgical cutting precision is improved.

Claims

1. The metal clamp dental floss integrated traction forceps for assisting in endoscopic submucosal stripping are characterized by comprising a controller I (1), a guide wire I (2), a metal clamp I (3), a controller II (4), a guide wire II (5), a metal clamp II (6), a sheath tube (7) and dental floss (8);

the controller I (1) is connected with the control end of the metal clamp I (3) through the guide wire I (2); the controller II (4) is connected with the control end of the metal clamp II (6) through the guide wire II (5); the guide wire I (2) and the guide wire II (5) are sleeved with a sheath tube (7) together; two ends of the dental floss (8) are respectively connected with clamp pipes of a metal clamp I (3) and a metal clamp II (6);

the length of the dental floss (8) is 1-3 cm; the distance between the metal clamp II (6) and the metal clamp I (3) is 1-3 cm, and the metal clamp II (6) and the metal clamp I (3) are arranged in a dislocation manner in the sheath tube (7);

the controller I (1) comprises an operating rod I (1.1), an operating handle thumb button I (1.2), a sliding sleeve I (1.3) and a pull ring I (1.4); the thumb buckle I (1.2) of the operating handle is arranged at the rear end of the operating rod I (1.1), the operating rod I (1.1) is sleeved with a sliding sleeve I (1.3), and pull rings I (1.4) are arranged on two sides of the sliding sleeve I (1.3); the controller I (1) controls the expansion and the clamping of the metal clamp I (3) through the guide wire I (2); the sliding sleeve I (1.3) slides along the operating rod I (1.1) to control the metal clamp I (3) to shrink in the port of the sheath tube (7) or extend out of the port of the sheath tube (7); the thumb buckle I (1.2) of the operating handle is used for fixing the operating rod I (1.1), and the pull ring I (1.4) is used for controlling the sliding sleeve I (1.3) to slide;

the controller II (4) comprises an operating rod II (4.1), an operating handle thumb button II (4.2), a sliding sleeve II (4.3) and a pull ring II (4.4); the operating handle thumb button II (4.2) is arranged at the rear end of the operating rod II (4.1), the operating rod II (4.1) is sleeved with a sliding sleeve II (4.3), and pull rings II (4.4) are arranged on two sides of the sliding sleeve II (4.3); the controller II (4) controls the expansion and the clamping of the metal clamp II (6) through the guide wire II (5); the sliding sleeve II (4.3) slides along the operating rod II (4.1) to control the metal clip II (6) to shrink in the port of the sheath tube (7) or extend out of the port of the sheath tube (7); the operating handle thumb button II (4.2) is used for fixing the operating rod II (4.1), and the pull ring II (4.4) is used for controlling the sliding sleeve II (4.3) to slide;

the guide wire I (2) is connected with or released from the metal clamp I (3); the guide wire II (5) is connected with or released from the metal clip II (6);

the two ends of the dental floss (8) are respectively connected with clamp pipes of the metal clamp I (3) and the metal clamp II (6), the controller I (1) and the controller II (4) are operated to enable the metal clamp I (3) and the metal clamp II (6) to be positioned inside a port of the sheath pipe (7) together with the dental floss (8), and the sheath pipe (7) is extended into a focus through an endoscope biopsy pore canal; operating the controller I (1) to enable the metal clip I (3) to extend out of the sheath tube (7) and be clamped on the focus with the cut edge, and then releasing the guide wire I (2) to be separated from the metal clip I (3); the controller II (4) is operated to enable the metal clip II (6) to extend out of the sheath tube (7) and be clamped on mucous membrane on the opposite side of the focus, and the metal clip II (6) pulls the metal clip I (3) through the dental floss (8), so that focus is pulled, and the stripping layer surface is effectively exposed to the field of view in the ESD operation.

2. A metal clip dental floss integrated pulling clamp for assisting endoscopic submucosal dissection according to claim 1, characterized in that the pulling clamp is positioned in the port of the sheath (7) when entering the gastrointestinal tract, metal clip i (3), metal clip ii (6) and dental floss (8); when the traction forceps work and clamp, the metal clamp I (3), the metal clamp II (6) and the dental floss (8) are positioned outside the port of the sheath tube (7).