CN115089265A - Fishing method two-mirror one-thread combined minimally invasive liver protection intrahepatic and extrahepatic bile duct calculus breaking and removing operation - Google Patents

Abstract

The invention relates to the technical field of medical instruments, and discloses a minimally invasive liver-protecting intrahepatic and extrahepatic bile duct calculus breaking and calculus removing operation by combining two mirrors and one wire in a fishing method. Insert the passageway with operation pipe and outer pipe, triangle shell fragment is at the closure state this moment, draw bar through the cover in the handle outwards stimulates a little during stone taking, the nylon rope that the pull bar drove connector rod top department removes, it opens to the outside simultaneously to come the pulling to pass the triangle shell fragment of getting a stone section of thick bamboo inner wall through the nylon rope, after wrapping up the calculus again, it makes nylon rope and triangle shell fragment resume to loosen the spring that the pull bar passes through the connector rod outside, make the closed back toper that forms of triangle shell fragment, be convenient for press from both sides the getting of rubble, omission can not appear.

Description

Fishing method, two mirrors and one wire combined minimally invasive liver protection and intrahepatic and extrahepatic bile duct calculus breaking and removing operation

Technical Field

The invention relates to the technical field of medical instruments, in particular to a minimally invasive liver-protecting and intrahepatic and extrahepatic bile duct calculus breaking and calculus removing method combining two mirrors and one wire by a fishing method.

Background

The pathogenesis of calculus of intrahepatic and extrahepatic bile ducts is related to bacterial infection, parasitic infection and bile retention of biliary tracts, and the intrahepatic bile duct lithiasis can be performed in various ways according to different disease courses and pathological conditions, and the clinical manifestations of calculus can be from the early stage without obvious clinical symptoms limited to calculus in a certain section of intrahepatic bile duct to the later stage of calculus in the intrahepatic and extrahepatic bile duct system and even complicated with late stage cases of biliary cirrhosis, hepatic atrophy, hepatic abscess and the like, and can be treated by double-mirror combination of auxiliary choledochoscope under a laparoscope.

At present, the step of getting of stone is comparatively loaded down with trivial details at the clamp of treatment in-process calculus, often misses the rubble easily getting the stone process, can't avoid getting the in-process, and the rubble of omitting causes the damage to internal wall and bleeds, influences the fastness of getting the in-process to when the great calculus of volume appears, the stone is difficult to handle when getting the clamp, reduces the whole security of getting the stone in-process.

Disclosure of Invention

Technical problem to be solved

Aiming at the defects of the prior art, the invention provides a minimally invasive liver protection intrahepatic and extrahepatic bile duct calculus breaking and taking operation combining two mirrors and one thread by a fishing method, has the advantages of large-volume calculus treatment, convenience in fetching calculus and clamping and the like, and solves the problem that the injury bleeding to the inner wall of the body caused by omission of the calculus in the clamping process cannot be avoided.

(II) technical scheme

In order to achieve the purpose, the invention provides the following technical scheme: a minimally invasive liver protection intrahepatic and extrahepatic bile duct calculus breaking and calculus removing operation combining two mirrors and one wire by a fishing method comprises an operation catheter, wherein the operation catheter is slidably mounted inside the outer catheter, a calculus removing barrel is fixedly mounted at the top end of the operation catheter, a calculus removing assembly is arranged at the top end of the calculus removing barrel and inside the outer catheter, a sleeve handle is arranged at the tail end of the operation catheter, and a calculus breaking mechanism is arranged at the joint of the sleeve handle and the operation catheter;

get the stone subassembly and include triangle shell fragment, nylon rope, connector rod, pull rod, elasticity fixture block, stopper and spring block, the inner wall movable mounting who gets a stone section of thick bamboo has the triangle shell fragment, the surface fixed connection of triangle shell fragment is on the top of nylon rope, the terminal fixedly connected with connector rod of nylon rope, the terminal fixed mounting of connector rod has the pull rod, the pull rod runs through in the end of operating the pipe, the surface movable mounting who gets a stone section of thick bamboo has the elasticity fixture block, the rear side of elasticity fixture block and be provided with corresponding stopper at the inner wall of outer pipe, the rear side of stopper runs through in the inside of outer pipe and is provided with the spring block.

Preferably, rubble mechanism is including rotating the post, colluding frame, arc pinion rack, toothed disc and crushing head, be provided with between the terminal of operation pipe and the cover handle and rotate the post, the opposite face that rotates the post and the inside of pipe outside is provided with colludes the frame, the inboard fixed mounting who colludes the frame has arc pinion rack, and is adjacent between the arc pinion rack and install toothed disc at the inside rotation of pipe outside, fixed surface installs the crushing head before the toothed disc.

Preferably, the opposite face of rotating the post and colluding the frame is provided with corresponding recess and card post respectively, smash the head and get the setting of stone section of thick bamboo for corresponding each other, the nylon rope runs through in the inside of toothed disc.

Preferably, the elastic clamping blocks and the limiting blocks are arranged in a corresponding trapezoidal structure, the triangular elastic sheet is arranged in a surrounding mode with the center of a stone taking cylinder as the standard, the outer surface of the connecting head rod is sleeved with the spring, and when the stone taking cylinder needs to be taken out, the spring block is pressed and the operation guide pipe is pushed by the aid of the trapezoid of the elastic clamping blocks and the limiting blocks and the spring block, so that stone taking and in-vitro stone taking are facilitated.

Preferably, the diameter of the calculus removing cylinder is smaller than that of the outer catheter, the diameter of the outer catheter is 2-6 mm, sliding grooves corresponding to the gear disc and the rotating column are respectively formed in the outer catheter, when the diameter of the calculus removing cylinder is smaller than that of the outer catheter, injury bleeding caused by the outside of the calculus removing cylinder to the inside of a human body is avoided when the calculus removing cylinder is taken out, and abrasion between the calculus removing cylinder and the human body is reduced.

According to the liver-protecting and internal and external bile duct calculus smashing and removing operation with the combination of the two mirrors and the one wire through the fishing method, the operation method with the combination of the two mirrors and the one wire through the fishing method and the minimally invasive liver-protecting and internal and external bile duct calculus smashing and removing operation with the fishing method is provided, and comprises the following steps:

s, intervention, namely cutting a small hole capable of being fed into an outer catheter to ensure that the outer catheter can be inserted, probing again, establishing a lithotomy channel and ensuring that the lithotomy channel is smooth;

s, fetching stones, conveying the stones into an operation catheter, and when stones are needed to be fetched, pulling the pull rods in the handles outwards slightly, pulling the triangular elastic sheets penetrating through the inner wall of the stone fetching barrel through nylon ropes, and meanwhile, opening outwards to wrap the stones;

s, protecting, namely holding the outer catheter after the calculus is wrapped, pulling the sleeve handle to drive the operating catheter to move upwards until the calculus taking barrel is clamped into the operating catheter, and extracting the calculus out of the body at a constant speed to collect the calculus;

s, checking, sending into a choledochoscope, and utilizing the choledochoscope to carry out 360-degree all-dimensional exploration on the interior of the calculus removing channel to ensure that no calculus is omitted;

s, closing the abdomen, sending the calculus removing channel into the laparoscope, and utilizing the laparoscope to carry out 360-degree all-dimensional exploration on the outside of the calculus removing channel so as to ensure that calculus cannot be omitted.

(III) advantageous effects

Compared with the prior art, the invention provides a minimally invasive liver protection intrahepatic and extrahepatic bile duct calculus breaking and calculus removing combined fishing method with two mirrors and one thread, and has the following beneficial effects:

1. this two mirrors of fishing method one silk are united wicresoft and are protected inside and outside liver bile duct calculus rubble and get stone art, in inserting the passageway with operation pipe and outer pipe, triangle shell fragment is at closed state this moment, when needing to get stone, outwards stimulate a little through the pull rod in the cover handle, the pull rod drives the nylon rope removal of connector rod top department, the triangle shell fragment that passes through a stone section of thick bamboo inner wall is come to the pulling through the nylon rope and is passed and open to the outside simultaneously, wrap up again and live behind the calculus, loosen the pull rod and make nylon rope and triangle shell fragment resume through the spring in the connector rod outside, form the toper after making the triangle shell fragment closed, press from both sides the calculus and get, be convenient for press from both sides the clamp of rubble, can not appear omitting.

2. This two mirrors of fishing method one silk unites wicresoft and protects inside and outside bile duct calculus rubble of liver and get stone art, hold the outer tube this moment after calculus parcel, pulling cover handle drives the operation pipe rebound, the terminal stone section of thick bamboo of getting of operation pipe contracts in the outer tube, compress until in the elastic fixture block contact outer tube behind the stopper, resume back and stopper when the elastic fixture block and make up carry on spacingly, thereby avoid the outside to cause the injury to the inner wall getting the stone in-process, increase and press from both sides the fastness of getting the in-process.

3. The fishing method combines the minimally invasive liver protection and intrahepatic and extrahepatic bile duct calculus breaking and calculus removing operation with two mirrors and one thread, and passes through the operation. When the calculus volume of getting it is great, after getting a stone section of thick bamboo shrink-in outer pipe, inside rotation post of operation pipe this moment and collude recess and the joint between the card post between the frame, mesh between inside toothed disc of concurrent operation pipe and the curved teeth board, rethread swivel sleeve handle drives and rotates the post and swings simultaneously, it makes curved teeth board and toothed disc meshing under the combination of frame to rotate the post and collude, the toothed disc drives and smashes the calculus that the head acts on in getting a stone section of thick bamboo and carries out simple rubble, conveniently take out external collection, thereby accomplish whole stone, rubble and integrative.

Drawings

FIG. 1 is a schematic perspective view of the present invention;

FIG. 2 is a schematic structural view of a closed state of a triangular spring plate according to the present invention;

FIG. 3 is a schematic view of the internal structure of the operating catheter and the outer catheter of the present invention;

FIG. 4 is a side cross-sectional view of the internal structure of FIG. 3A-A;

fig. 5 is a schematic view of the internal structure of the stone removing cylinder of the present invention.

Wherein: 1. operating the catheter; 2. an outer catheter; 3. taking a stone barrel; 4. a stone taking component; 401. a triangular spring plate; 402. a nylon cord; 403. a connecting head rod; 404. a pull rod; 405. an elastic clamping block; 406. a limiting block; 407. a spring block; 5. sleeving a handle; 6. a stone breaking mechanism; 601. rotating the column; 602. hooking a frame; 603. an arc toothed plate; 604. a gear plate; 605. a pulverizing head.

Detailed Description

The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.

Referring to fig. 1-5, a minimally invasive liver protection intrahepatic and extrahepatic bile duct calculus breaking and removing technique by a fishing method with two mirrors and one wire combined comprises an operation catheter 1, wherein the operation catheter 1 is slidably mounted inside an outer catheter 2, a calculus removing barrel 3 is fixedly mounted at the top end of the operation catheter 1, the diameter of the calculus removing barrel 3 is smaller than that of the outer catheter 2, the diameter of the outer catheter 2 is 2-6 mm, a calculus removing assembly 4 is arranged at the top end of the calculus removing barrel 3 and inside the outer catheter 2, a sleeve handle 5 is arranged at the tail end of the operation catheter 1, the calculus removing assembly 4 comprises a triangular elastic sheet 401, a nylon rope 402, a connecting head rod 403, a pull rod 404, an elastic clamping block 405, a limiting block 406 and a spring block 407, the triangular elastic sheet 401 is movably mounted on the inner wall of the calculus removing barrel 3, the outer surface of the triangular elastic sheet 401 is fixedly connected to the top end of the nylon rope 402, the tail end of the nylon rope 402 is fixedly connected with a connecting head rod 403, a pull rod 404 is fixedly installed at the tail end of the connecting head rod 403, the pull rod 404 penetrates through the tail end of the operation guide pipe 1, an elastic clamping block 405 is movably installed on the outer surface of the stone taking barrel 3, a corresponding limiting block 406 is arranged on the rear side of the elastic clamping block 405 and on the inner wall of the outer guide pipe 2, a spring block 407 is arranged on the rear side of the limiting block 406 and inside the outer guide pipe 2 in a penetrating mode, the elastic clamping block 405 and the limiting block 406 are arranged in a corresponding trapezoidal structure, the triangular elastic piece 401 is arranged in a surrounding mode with the center of the stone taking barrel 3 as the standard, and a spring is sleeved on the outer surface of the connecting head rod 403.

Through above-mentioned technical scheme, when needing to get the stone, outwards stimulate a little through pull rod 404 in the cover handle 5, pull rod 404 drives the nylon rope 402 removal of connecting rod 403 top department, comes the pulling to pass the triangle shell fragment 401 of getting the 3 inner walls of stone section of thick bamboo to open to the outside simultaneously through nylon rope 402, wraps up the calculus again after, prevents the phenomenon of omission.

Specifically, as shown in fig. 3, a stone breaking mechanism 6 is arranged at the joint of the sleeve handle 5 and the operation conduit 1, the stone breaking mechanism 6 comprises a rotating column 601 and a hook frame 602, arc toothed plate 603, toothed disc 604 and crushing head 605, be provided with between the terminal of operation pipe 1 and the cover handle 5 and rotate post 601, the opposite face that rotates post 601 and the inside of pipe 2 outside is provided with colludes frame 602, the opposite face that rotates post 601 and colludes frame 602 is provided with corresponding recess and card post respectively, the inboard fixed mounting that colludes frame 602 has arc toothed plate 603, between adjacent arc toothed plate 603 and in the inside rotation of pipe 2 outside install toothed disc 604, the inside of pipe 2 is provided with respectively with toothed disc 604 and the corresponding spout of rotation post 601, fixed surface installs crushing head 605 before toothed disc 604, crushing head 605 and stone extraction section of thick bamboo 3 are the mutual corresponding setting, nylon rope 402 runs through in the inside of toothed disc 604.

Through the technical scheme, hold outer pipe 2 this moment after the calculus parcel, pulling cover handle 5 drives operation pipe 1 and upwards removes, operation pipe 1 end get in the stone section of thick bamboo 3 retracts outer pipe 2, compress until elasticity fixture block 405 contacts stopper 406 in the outer pipe 2, it is spacing to resume the back and make up between the stopper 406 when elasticity fixture block 405, when needing to take out the calculus in getting the stone section of thick bamboo 3, press spring block 407 and promote operation pipe 1 can, be convenient for get stone and external stone of getting.

According to the fishing method combining two mirrors and one screw for minimally invasive liver protection intrahepatic and extrahepatic bile duct calculus breaking and calculus removing, the operation method combining two mirrors and one screw for minimally invasive liver protection intrahepatic and extrahepatic bile duct calculus breaking and calculus removing is provided, and comprises the following steps:

s1, intervening, namely cutting a small hole which can be sent into the outer catheter 1 to ensure that the outer catheter 2 can be inserted, probing again, and establishing a lithotomy channel to ensure that the lithotomy channel is smooth;

s2, fetching stones, feeding into the operation catheter, when stones are needed to be fetched, pulling outwards slightly through the pull rod 404 in the sleeve handle, pulling the triangular elastic sheet 401 penetrating through the inner wall of the stone fetching barrel 3 through the nylon rope, and meanwhile, opening outwards to wrap the stones;

s3, protecting, holding the outer catheter 2 after the calculus is wrapped, pulling the sleeve handle 5 to drive the operation catheter 2 to move upwards until the calculus taking barrel 3 is clamped into the operation catheter 1, and then collecting the calculus after being drawn out of the body at a constant speed;

s4, checking, sending into a choledochoscope, and utilizing the choledochoscope to carry out 360-degree all-dimensional exploration on the interior of the lithotomy passage to ensure that no calculus is omitted;

s5, closing the abdomen, sending into the laparoscope, and utilizing the laparoscope to carry out 360-degree all-dimensional exploration on the outside of the calculus removing channel to ensure that calculus cannot be missed.

When the device is used, after the stone taking channel is confirmed to be smooth, the operation catheter 1 and the outer catheter 2 are inserted into the channel, the triangular spring plate 401 is in a closed state, when the stone needs to be taken, the pull rod 404 in the sleeve handle 5 is slightly pulled outwards, the pull rod 404 drives the nylon rope 402 at the top end of the connecting head rod 403 to move, the triangular spring plate 401 penetrating through the inner wall of the stone taking barrel 3 is pulled through the nylon rope 402 and is simultaneously opened outwards, the stone is wrapped, the pull rod 404 is loosened to recover the nylon rope 402 and the triangular spring plate 401 through the spring at the outer side of the connecting head rod 403, the triangular spring plate 401 is closed to form a cone shape, the stone is clamped, the crushed stone is conveniently clamped, the crushed stone is not missed, the outer catheter 2 is clamped after the stone is wrapped, the sleeve handle 5 is pulled to drive the operation catheter 1 to move upwards, the stone taking barrel 3 at the tail end of the operation catheter 1 retracts into the outer catheter 2 until the elastic clamping block 405 contacts with the limiting block 406 in the outer catheter 2 and then is compressed, the combination is spacing after elastic fixture block 405 resumes and between the stopper 406, thereby avoid the outside to cause the injury to the inner wall at the stone taking in-process, increase and press from both sides the fastness of getting the in-process, when the stone volume of getting is great when pressing from both sides, after getting stone section of thick bamboo 3 retraction outer catheter 2, the rotation post 601 of operating duct 1 inside this moment and colluding between the frame 602 recess and the joint between the post, mesh between the inside toothed disc 604 of operating duct 1 and the curved tooth board 603 simultaneously, drive through swivel mount handle 5 again and rotate post 601 and swing simultaneously, make curved tooth board 603 and toothed disc 604 mesh under the combination of rotating post 601 and colluding frame 602, toothed disc 604 drives the stone that rubble head 605 acted on in getting stone section of thick bamboo 3 and carries out simple rubble, conveniently take out the external collection, thereby accomplish whole stone taking, rubble and integrative.

Although embodiments of the present invention have been shown and described, it will be appreciated by those skilled in the art that changes, modifications, substitutions and alterations can be made in these embodiments without departing from the principles and spirit of the invention, the scope of which is defined in the appended claims and their equivalents.

Claims (6)

1. A minimally invasive liver protection intrahepatic and extrahepatic bile duct calculus breaking and calculus removing operation combining two mirrors and one wire by a fishing method comprises an operation catheter (1), and is characterized in that: the operation catheter (1) is slidably mounted inside the outer catheter (2), a stone taking barrel (3) is fixedly mounted at the top end of the operation catheter (1), a stone taking assembly (4) is arranged at the top end of the stone taking barrel (3) and inside the outer catheter (2), a sleeve handle (5) is arranged at the tail end of the operation catheter (1), and a stone crushing mechanism (6) is arranged at the joint of the sleeve handle (5) and the operation catheter (1);

the stone taking component (4) comprises a triangular elastic sheet (401), a nylon rope (402), a connecting head rod (403), a pull rod (404), an elastic clamping block (405), a limiting block (406) and a spring block (407), a triangular spring plate (401) is movably arranged on the inner wall of the stone taking barrel (3), the outer surface of the triangular spring plate (401) is fixedly connected with the top end of a nylon rope (402), the tail end of the nylon rope (402) is fixedly connected with a connecting head rod (403), the tail end of the connecting head rod (403) is fixedly provided with a pull rod (404), the pull rod (404) penetrates through the tail end of the operation guide pipe (1), an elastic clamping block (405) is movably arranged on the outer surface of the stone taking barrel (3), a corresponding limit block (406) is arranged at the rear side of the elastic fixture block (405) and on the inner wall of the outer conduit (2), the rear side of the limiting block (406) penetrates through the inner part of the outer guide pipe (2) and is provided with a spring block (407).

2. The fishing method with two mirrors and one thread combined minimally invasive liver protection intrahepatic and extrahepatic bile duct calculus smashing and calculus removing technology according to claim 1, is characterized in that: rubble mechanism (6) including rotating post (601), colluding frame (602), arc pinion rack (603), toothed disc (604) and crushing head (605), be provided with between the end of operation pipe (1) and cover handle (5) and rotate post (601), the opposite face that rotates post (601) and the inside of outer pipe (2) are provided with colludes frame (602), the inboard fixed mounting who colludes frame (602) has arc pinion rack (603), and is adjacent just install toothed disc (604) in the inside rotation of outer pipe (2) between arc pinion rack (603), fixed surface installs crushing head (605) before toothed disc (604).

3. The fishing method with two mirrors and one thread combined minimally invasive liver protection intrahepatic and extrahepatic bile duct calculus smashing and calculus removing technology according to claim 2, is characterized in that: the opposite surfaces of the rotating column (601) and the hook frame (602) are respectively provided with a corresponding groove and a corresponding clamping column, the crushing head (605) and the stone taking barrel (3) are arranged in a corresponding mode, and the nylon rope (402) penetrates through the inner portion of the gear disc (604).

4. The fishing method with two mirrors and one thread combined minimally invasive liver protection intrahepatic and extrahepatic bile duct calculus smashing and calculus removing technology according to claim 1, is characterized in that: the elastic clamping block (405) and the limiting block (406) are arranged in a corresponding trapezoidal structure, the triangular elastic sheet (401) is arranged in a surrounding mode by taking the circle center of the stone taking barrel (3) as the standard, and a spring is sleeved on the outer surface of the connecting head rod (403).

5. The fishing method with two mirrors and one thread combined minimally invasive liver protection intrahepatic and extrahepatic bile duct calculus smashing and calculus removing technology according to claim 2, is characterized in that: the diameter of the stone taking barrel (3) is smaller than that of the outer guide pipe (2), the diameter of the outer guide pipe (2) is 2-6 mm, and sliding grooves corresponding to the gear disc (604) and the rotating column (601) are respectively formed in the outer guide pipe (2).

6. The fishing method with two mirrors and one screw combined minimally invasive liver protection intrahepatic and extrahepatic bile duct calculus breaking and calculus removing operation method according to claim 1 is provided, and is characterized in that: the method comprises the following steps:

s1, intervening, namely cutting a small hole which can be sent into the outer catheter (1) to ensure that the outer catheter (2) can be inserted, probing again, establishing a lithotomy channel and ensuring that the lithotomy channel is unobstructed;

s2, fetching stones, feeding into the operation catheter, and when stones are needed to be fetched, pulling outwards slightly through a pull rod (404) in a sleeve handle, pulling a triangular elastic sheet (401) penetrating through the inner wall of the stone fetching barrel (3) through a nylon rope, and meanwhile, opening outwards to wrap the stones;

s3, protection, wherein the outer catheter (2) is held after the calculus is wrapped, the sleeve handle (5) is pulled to drive the operation catheter (2) to move upwards until the calculus removing barrel (3) is clamped into the operation catheter (1), and calculus collection is carried out after the calculus removing barrel is drawn out of the body at a constant speed;

s4, checking, sending into a choledochoscope, and utilizing the choledochoscope to carry out 360-degree all-dimensional exploration on the interior of the lithotomy passage to ensure that no calculus is omitted;

s5, closing the abdomen, sending into the laparoscope, and utilizing the laparoscope to carry out 360-degree all-dimensional exploration on the outside of the calculus removing channel to ensure that calculus cannot be missed.

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