CN115581428A

CN115581428A - Mirror for urinary surgery

Info

Publication number: CN115581428A
Application number: CN202211093461.9A
Authority: CN
Inventors: 程跃; 施静宇; 方立; 李强
Original assignee: Ningbo First Hospital
Current assignee: Ningbo First Hospital
Priority date: 2022-09-08
Filing date: 2022-09-08
Publication date: 2023-01-10

Abstract

The invention provides a urinary surgery mirror which comprises an expanding sheath and a nephroscope main body, wherein the expanding sheath is detachably sleeved on the nephroscope main body. The nephroscope body has an outer end face. The outer terminal surface is provided with one and inhales the row mouth, keeps under the unchangeable prerequisite of radial length, has increased and has inhaled the discharge space that the row mouth is used for the rubble, is turned back extremely in the kidney inner wall by the flush fluid of injection the inhaling row mouth forms a vortex, is convenient for wrap up and hold by kibbling kidney stone for the discharge efficiency to the rubble. The outer end face is provided with a visual portion, and the visual portion is arranged at the rear end of the suction and discharge port to observe the blocking condition of the suction and discharge port.

Description

Mirror for urinary surgery

Technical Field

The invention relates to the field of medical instruments, in particular to a mirror for urinary surgery.

Background

As a disease with high incidence in the urinary system, kidney stones often afflict many people and cause abnormal phenomena such as pain and the like.

Percutaneous nephrolithotomy is a surgical procedure for treating kidney stones, and is used to treat larger particulate stones that accumulate in the kidney. Percutaneous nephrolithotomy, as a widely used surgical procedure, still has many problems in the specific operation process.

After a conventional percutaneous nephroscope uses laser to crush calculi, crushed debris flows in through a gap between the percutaneous nephroscope and an extension sheath inserted in a fitting manner along with a flushing fluid. Since the percutaneous nephroscope is a minimally invasive operation, the wound of the injured person is ensured to be as small as possible, and thus the whole percutaneous nephroscope is also made small. The traditional percutaneous nephroscope structure does not centralize the flushing and sucking part, and a channel for discharging flushing liquid is arranged on the side of the periphery of the percutaneous nephroscope on the nephroscope body with smaller inner diameter, so that the problem that the channel is blocked by un-crushed and clean stones is easy to occur. The blockage problem of the discharge channel easily causes the series problems of overlarge pressure difference in the kidney, damage of percutaneous nephroscope equipment and the like.

In the process of inserting the traditional percutaneous nephroscope into the kidney dilatation part, although the use scene can be matched with X-ray intermittent perspective monitoring, the position of the camera is also arranged at the front end of the main scope body so as to ensure that a better visual field range is obtained. However, the camera cannot observe the blockage of the discharge channel at the rear side of the camera, and the visualization processing for completely covering the key parts of the equipment cannot be realized.

In the process of flushing and sucking inside the renal pelvis, the traditional percutaneous nephroscope cannot generate strong liquid backflow due to the arrangement problem of the suction and discharge port and the flushing port, so that sufficient force cannot be provided for sucking crushed stones. The efficiency of discharging the washing fluid is low, and the intrarenal pressure is increased, so that the renal pelvis burst and the like are likely to occur.

Thus, there is a need for an optimized nephroscope structure to prevent blockage of the debris and to improve the efficiency of debris removal.

Disclosure of Invention

One advantage of the present invention is to provide a urological scope that integrates suction and discharge, and at the same time, adopts a centralized channel on the outer end surface to ensure that the size of the suction and discharge port is large enough.

Another advantage of the present invention is to provide a mirror for urinary surgery, wherein the flushing port of the mirror for urinary surgery is disposed on the surrounding side surface, and the suction port disposed on the outer end surface is folded back on the inner wall of the kidney to form a vortex, thereby promoting the circulation of the flushing fluid.

Another advantage of the present invention is to provide a urological scope, the main scope body of which is tapered to facilitate insertion of the urological scope into a patient during a surgical procedure, thereby reducing the operational difficulty of an operator and further reducing the injury to the patient during the access procedure.

It is another advantage of the present invention to provide a urological scope with a dilating sheath attached to the body of the nephroscope to provide dilating support as a bridge passage for stable access to the kidneys.

Another advantage of the present invention is to provide a urological scope having a viewing portion disposed at a rear end of a suction port, the suction port being located within a field of view of the viewing portion to observe blockage of the suction port.

Another advantage of the present invention is to provide a urological scope that has a small footprint for the remaining channels, and that reserves the size of the drainage channel to increase the size of the suction port.

Another advantage of the present invention is to provide a urological scope, which preferably uses an electronic scope as a visual portion, and simplifies the connection of the visual portion and optimizes the routing layout of the connection wires.

Another advantage of the present invention is to provide a urological scope having an infusion channel independent of the discharge channel, optimizing channel placement, reducing interference with each other, and providing urolith removal efficiency.

Another advantage of the present invention is to provide a urological scope that avoids erroneous puncturing with a visible portion during a surgical procedure, thereby reducing the risk of injury to the patient.

Another advantage of the present invention is to provide a urological scope having an instrument port through which a lithotripsy instrument can be used to lithotripsy the inside of the kidney, with the use of flushing fluid during lithotripsy, ensuring a clear field of view of the visible portion.

According to an aspect of the present invention, the present invention provides a urological endoscope, the urological endoscope includes an expanding sheath and a nephroscope main body, wherein the expanding sheath is detachably sleeved on the nephroscope main body, the nephroscope main body includes a main scope body and a visible portion, the main scope body has an outer end surface, the main scope body includes a first working area and a second working area, a suction/discharge port is located in the second working area, the first working area surrounds the second working area, the visible portion is located in the first working area, the main scope body is provided with a flushing port, the main scope body has a discharge channel and an injection channel, the discharge channel is communicated with the suction/discharge port, the injection channel is communicated with the flushing port, and the discharge channel and the injection channel are independent from each other.

Drawings

FIG. 1 is a schematic view of a urological scope according to a preferred embodiment of the present invention in an assembled state.

Figure 2 is an exploded view of the urological scope according to the above preferred embodiment of the present invention in an assembled state.

Figure 3A is a partial schematic view of the expanding sheath of the urological scope according to the above preferred embodiment of the present invention.

Figure 3B is a partial cross-sectional view of the urological scope according to the above preferred embodiment of the present invention.

Figure 4 is a partial schematic view of the extended sheath of the urological scope according to the above preferred embodiment of the present invention.

Figure 5A is one of the schematic views of the urological scope according to the above preferred embodiment of the present invention.

Figure 5B is one of the schematic views of the urological scope according to the above preferred embodiment of the present invention.

Figure 5C is one of the schematic views of the urological scope according to the above preferred embodiment of the present invention.

Detailed Description

The following description is provided to disclose the invention so as to enable any person skilled in the art to practice the invention. The preferred embodiments in the following description are given by way of example only, and other obvious variations will occur to those skilled in the art. The basic principles of the invention, as defined in the following description, may be applied to other embodiments, variations, modifications, equivalents, and other technical solutions without departing from the spirit and scope of the invention.

It will be understood by those skilled in the art that in the present disclosure, the terms "longitudinal," "lateral," "upper," "lower," "front," "rear," "left," "right," "vertical," "horizontal," "top," "bottom," "inner," "outer," and the like are used in an orientation or positional relationship indicated in the drawings for ease of description and simplicity of description, and do not indicate or imply that the referenced devices or components must be in a particular orientation, constructed and operated in a particular orientation, and thus the above terms are not to be construed as limiting the present invention.

It is understood that the terms "a" and "an" should be interpreted as meaning that a number of one element or element is one in one embodiment, while a number of other elements is one in another embodiment, and the terms "a" and "an" should not be interpreted as limiting the number.

As shown in fig. 1 to 5C, a urological scope according to a preferred embodiment of the present invention is illustrated. The urological endoscope 1 is suitable for being applied to percutaneous nephrolithotomy, and in the operation process of the operation, a doctor operates a puncture needle 2 to enable the outer skin of a human body and the kidney K to penetrate through the puncture needle in a straight line mode, and leads 3 to build a bridge channel inside the outer skin and the kidney K. Then the puncture needle 2 is pulled out, the urological scope 1 is inserted into the channel along the guide wire 3, and finally the crushing and recovery work of the kidney stone S is carried out inside the kidney K. During the lithotripsy process, the lithotripsy device which passes through the urology operation mirror 1 is cooled along with the flushing of the flushing liquid, and the flushing liquid carries crushed lithotripsy in the flushing process. The flush fluid is followed it is inside that uropoiesis for operation mirror 1 is directly supported kidney K to turn back in kidney K inner wall extremely uropoiesis for operation mirror 1 forms a vortex, the vortex is suitable for to wrap up and hold kidney stone S by shredding. Finally, the crushed kidney stone S is discharged out of the body, and the operation is finished.

As shown in fig. 1 to 2, the urological endoscope 1 includes an expanding sheath 10 and a nephroscope main body 20, and the expanding sheath 10 is detachably sleeved on the nephroscope main body 20. In the present embodiment, the structural rigidity of the expanding sheath 10 is greater than that of the nephroscope body 20. That is, the expanding sheath 10 provides sufficient rigidity to the nephroscope body 20. When the urological endoscope 1 enters the channel along the guide wire 3, the outer wall of the expanding sheath 10 abuts against the inner wall of the channel. That is, the expanding sheath 10 supports the nephroscope body 20 inside the kidney K. In other words, since the puncture needle 2 cuts the channel open, the skin has the characteristic of self-healing, and in order to prevent the skin from being automatically closed by the cut sides, the expanding sheath 10 widens and stabilizes the channel within the safe range of the operation, which facilitates the entry of the nephroscope body 10. Thus, the nephroscope body 10 should also remain within the safe confines of the procedure.

For convenience of explanation, the urological scope 1 is defined herein as being the inner side where the urological scope 1 is inserted into the skin and the outer side where the urological scope 1 is away from the skin during a surgical procedure. The medial side is defined as the anterior end and the lateral side is defined as the posterior end.

The nephroscope body 20 has an outer end face 210 and a surrounding side face 220, the outer end face 210 being disposed inside the urological scope 1. The surrounding side surface 220 surrounds the side of the outer end surface 210, that is, the surrounding side surface 220 extends from the outer edge of the outer end surface 210 rearward along the axial direction of the nephroscope body 20. In one embodiment, the plane of the outer end surface 210 is perpendicular to the plane of the surrounding side surface 220, and in another embodiment, the plane of the outer end surface 210 and the plane of the surrounding side surface 220 intersect each other obliquely.

In one embodiment of the present invention, the urological scope 1 has an exit channel 212 and an infusion channel 213. The injection channel 213 is adapted for the passage of irrigation fluid from the outside towards the human kidney K. The outlet channel 212 is adapted for the passage of irrigant from the kidney K towards the outside. That is, the flushing liquid can be introduced into the inside of the kidney K along the injection passage 213 to perform the flushing operation and then the flushing waste water can be recovered along the discharge passage 212. The injection channel 213 and the discharge channel 212 are independent from each other, so that the arrangement of the channels is optimized, and the stone discharging efficiency is improved.

It is worth mentioning that the radial area of the discharge channel 212 is larger than that of the injection channel 213. The stone crusher passes through when urology operation gets into inside the smashing kidney stone S of kidney K with mirror 1, the flush fluid has played the effect of cooling and wrapping up in and hold the rubble and retrieve. The discharge channel 212 therefore also has to be used for the circulation of the ballast. In contrast to conventional percutaneous nephroscopes, the original path for the passage of the debris is diverted from the annular gap between the nephroscope body 20 and the expanding sheath 10 into the drainage channel 212 of today. The broken stones are easier to be discharged out of the body, and the condition of broken stone blockage is greatly reduced.

As shown in FIGS. 3A and 3B, the nephroscope body 20 includes a main scope body 21, and the main scope body 21 includes a main scope tube 211 and has an exhaust channel 212 and an injection channel 213. The discharge channel 212 and the injection channel 213 are provided to the main scope tube 211. Further, the discharge passage 212 and the injection passage 213 are provided to penetrate the outer end surface 210. The urological endoscope 1 comprises a suction port 60 and a flushing port 70, wherein the suction port 60 is communicated with the discharge channel 212, and the flushing port 70 is communicated with the injection channel 213. In the present embodiment, the flushing port 70 is provided to the outer end surface 210 such that the flushing port 70 is located at the end of the nephroscope body 20. The diameter of the suction opening 60 is larger than the diameter of the flushing opening 70. The flushing port 70 is adapted to deliver a flushing fluid to the kidney K and the suction port 60 is adapted to absorb residual flushing fluid including debris entrained in the flushing fluid within the kidney K. That is to say, the washing liquid process the injection passageway 213 by inside the washing mouth 70 gets into kidney K, borrow the inner wall backward flow of kidney K while scouring and cooling to radial area is great the suction and discharge mouth 60 wraps up and carries the rubble and get into discharge passageway 212, finally discharge is external. In other words, the channels for flushing and sucking of the urological scope 1 are isolated from each other and do not affect each other. Thus, the flushing fluid passes through the injection passage 213 and the flushing port 70, and the flushing fluid and the crushed stone pass through the discharge passage 212 and the suction port 60.

In the operating state of the urological scope 1, the operator can suck and collect the irrigation fluid in the kidney K by the suction device communicating with the discharge passage 212. In the suction process, a pressure difference is formed inside the kidney K, so that crushed stones and the like are easily discharged to the outside of the body along with the discharge passage 212. Although percutaneous nephrolithotomy is a minimally invasive procedure, it is still necessary to control the wound to be within a safe surgical range, so that the radial area of the expanding sheath 10 fitted over the nephroscope body 20 is not too large. Further, the discharge path of the crushed stone is improved so that the arrangement of the outer end surface 210 of the urological scope 1 is concentrated. Compared with the traditional percutaneous nephroscope, the allowable passing range of the annular gap is smaller, the allowable discharge volume of the gravels is greatly increased by the sectional shape of the suction and discharge port 60, and the situation that the suction and discharge port 60 is blocked is not easy to occur. For example, the cross-sectional shape of the suction port 60 may be a circular shape, a crescent shape, or the like, which allows crushed stones to pass through, but is not limited thereto.

The nephroscope body 20 further includes an operation portion 23, and the operation portion 23 is provided outside the urology operation scope 1. That is, the operation unit 23 is connected to the rear end of the main scope 21. Specifically, the operation portion 23 is an operation handle that is easy for an operator to hold and use. The operation portion 23 has a first operation chamber 231 and a second operation chamber 232. The first operation chamber 231 is adapted to communicate with the discharge channel 212 and the second operation chamber 232 communicates with the injection channel 213. That is, the apparatus for injecting the washing liquid injects the washing liquid into the injection passage 213 through the second operation chamber 232, and the residual washing liquid and the entrained crushed stones are discharged to the outside of the body through the discharge passage 212 by self-circulation inside the kidney K and the first operation chamber 231.

The operation portion 23 further has a third operation chamber 233, and the urological scope 1 further includes an instrument port 80. The third operating lumen 233 is disposed outside the urological scope 1. The instrument opening 80 is provided inside the urological scope 1. The third operation cavity 233 is communicated with the instrument port 80 to allow a lithotriptor to pass through. That is, the lithotripter extends from the instrument opening 80 to the inside of the kidney K through the third operation lumen penetrating the urology scope 1 to perform lithotripsy. In other words, the instrument port and the third operation lumen 233 provide a lithotripsy instrument to communicate to the inside of the kidney K. In this embodiment, the lithotripsy instrument is optionally a surgical instrument such as a lithotripsy fiber, and is not intended to limit the present invention.

As shown in fig. 1 to 2, the operation portion 23 is integrally connected to the main mirror 21, or the main mirror 21 is detachably connected to the operation portion 23. When the expanding sheath 10 is sleeved on the main endoscope body 21, the expanding sheath 10 is detachably connected to the operation part 23. That is, the expanding sheath 10 is detachably mounted to the nephroscope body 20.

The expanding sheath 10 includes an inner end portion 111, an outer end portion 112 and an intermediate portion 113, the inner end portion 111 is located inside the urology scope 1, the outer end portion 112 is located outside the urology scope 1, and the intermediate portion 113 is located in a region between the inner end portion 111 and the outer end portion 112. The outer end 112 has an internal thread, and the connecting portion of the operating portion 23 and the main mirror body 21 is surrounded by an external thread adapted to fit the internal thread. Thereby, the outer end 112 of the expanding sheath 10 is detachably connected to the operating portion 23. That is, the expanding sheath 10 is detachably connected to the nephroscope body 20. The expanding sheath 10 further has an inner side adapted to abut against the surrounding sidewall and an outer side adapted to abut against a channel formed by the puncture needle and the skin to support the main scope body as a set-up channel.

It is worth mentioning that the radial area of the expanding sheath 10 decreases from the outer end 112 to the inner end 111. That is, the cross-sectional area of the outer end portion 112 is smaller than the cross-sectional area of the inner end portion 111. When an operator pierces the urological endoscope 1 entering along the guide wire 3 into the skin during a surgical procedure, the inner end 111 of the expanding sheath 10 is more easily inserted into the skin, and the phenomenon that the skin at the pierced position is seriously damaged due to the excessively large radial area of the inner end 111 is prevented.

More particularly, the expanding sheath 10 further has an expanding cavity 11, and the expanding cavity 11 is suitable for storing the main endoscope body 21. That is, the main mirror body 21 is embedded in the expansion cavity 11. The main mirror body 21 is tapered from the rear end to the front end. In other words, the radial area of the primary mirror body 21 decreases gradually from the side away from the outer end face 210 to the outer end face 210 side. Further, the shape of the primary mirror body 21 tends to be a frustum, the upper bottom surface of which corresponds to the outer end surface 210. The shape of the main scope body 21 also facilitates insertion of the nephroscope body 20 into the skin up to the inside of the kidney K.

As shown in fig. 3A to 4, the nephroscope body 20 further includes a visible portion 22, and the visible portion 22 is disposed inside the urological scope 1. Further, the viewing portion 22 is provided on the outer end surface 210 so as to face in the same direction as the direction from the discharge passage 212 to the suction port 60. During the operation, the position to be operated, namely the kidney dilating part of the kidney K can be accurately reached by matching with the intermittent X-ray irradiation and the visualization of the visible part 22. The potential safety hazard caused by too deep puncture or too shallow puncture can not occur. Specifically, in the present embodiment, the viewing portion 22 is preferably formed by a camera, and the viewing portion 22 is disposed flush with the flushing port 70 and the instrument port 80. Further, in some embodiments, the visualization portion 22 is disposed between the irrigation port 70 and the instrument port 80. During the lithotripsy process, the visible part 22 can easily observe the lithotripsy condition. That is, the progress of the surgical lithotripsy is maintained by the visible portion 22.

The main mirror 21 includes a first working area 2101 and a second working area 2102. The first workspace 2101 surrounds the second workspace 2102. That is, the second work area 2102 is surrounded by the first work area 2101. The outer edge of the first working area 2101 extends axially along the main mirror 21 in succession to form the circumferential side 220. Further, the second working area 2102 includes the suction and discharge port 60 disposed at a central region of the outer end surface 210. The visualization portion 22, the flush port 70, and the instrument port 80 are located in the first working area 2101. The visualization portion 22, the flush port 70, and the instrument port 80 are isolated from one another. Such elements have less influence on the position arrangement. And the second working area 2102 includes an outer peripheral side of the suction port 60. That is, in one embodiment, the shape of the orthographic projection of the suction and discharge port 60 in the axial direction is crescent; in another embodiment, the orthographic projection of the suction port 60 in the axial direction is circular in shape. The cross-sectional shape of the suction/discharge port 60 is not limited, and crushed stone can be allowed to pass through. In particular, the arrangement of the second working area 2102 is more critical than the arrangement of the first working area 2101, and expanding the arrangement of the second working area 2102 to determine the renal stones S to be crushed while maintaining the overall radial area of the outer end surface 210.

It is worth mentioning that the suction port 60 is located in the second working area 2102 and the visible part 22 is located in the first working area 2101. In order to cover the range of the visual field of the visual part 22 as much as possible to the suction/discharge port 60, which is an important component of the urological scope 1, during the operation. In one embodiment, as shown in FIG. 3A, the suction/discharge port 60 is disposed at the front end of the viewing portion 22, and specifically, the suction/discharge port 60 is disposed closer to the inner side of the urological scope 1 than the viewing portion 22. That is, the visual part 22 can easily observe the blockage of the suction port 60. In other words, the suction port 60 is located within the visual field of the visual portion 22. In another embodiment, as shown in fig. 4, the suction port 60 and the viewing portion 22 are disposed in the same plane, and the suction port 60 is not visible to the viewing portion 22.

It should be further noted that in the preferred embodiment, the nephroscope body has a steep area and a gentle area, the plane of the gentle area is parallel to the plane of the main mirror body 21 in the radial direction, and the plane of the steep area and the plane of the main mirror body 21 in the radial direction are obliquely intersected with each other. Further, the viewing portion 22 is located at the flat zone, and the suction port 60 is located at the steep zone, so that the suction port 60 is located at the front end of the viewing portion 22 under the condition that the radial section of the outer end surface 210 is kept unchanged. That is, the suction port 60 is located within the visible range of the visible portion 22. In other words, the visual portion 22 can observe the blockage of the suction port 60.

The visible part 22 is communicated with an image transmission device, that is, an operator can connect the image transmission device to project the image observed by the visible part 22, so that the urological operation mirror 1 can be accurately inserted into a proper kidney expansion position, and the operation safety is enhanced. The puncture distance is too shallow, so that the kidney stone S cannot be reached, and the stone breaking work cannot be finished; too deep a puncture distance may touch the venous blood vessels, resulting in blood outflow, creating a life risk for the patient. Thus, the proper penetration distance makes the visualization portion 22 of irrevocable importance for controlling the entry position of the urological scope 1.

In the process of lithotripsy, the lithotripsy apparatus crushes the kidney stone S through the apparatus port 80, and sucks and discharges the washing fluid carrying the crushed stone from the suction port 60 to the outside of the body along with the self-circulation of the washing fluid in the kidney K. Thus, the suction force from the flushing port 70 to the suction port 60 is required. Too large a suction force of the suction device provided in the suction port 60 causes the rinse liquid to be discharged from the injection channel 213 to the discharge channel 212 directly from the suction port 60 immediately after being discharged from the rinse port 70, i.e., sucked by the suction device. The crushed stone generated in the crushing process can not be wrapped in the process, so that the crushed kidney stone S still remains in the kidney K, and the inner wall of the kidney K is scratched along with the erratic collision of the liquid in the kidney K, and the kidney K is damaged.

When suction device's appeal can lead to the flush fluid certainly pour into passageway 213 follow the discharge of sluicing mouth 70 is set up in the unable flush fluid recovery that injects of suction device of suction mouth 60 directly leads to the pressure increase in the kidney K, very easily appears the too big phenomenon of damaging kidney K of water pressure in the kidney K. Whereby the suction force of the suction device must be reasonably controlled. In contrast, the operation unit 23 is provided with an air valve regulator that controllably regulates the suction force of the suction device, thereby controlling the air pressure in the kidney K to be stable.

In particular, in one embodiment, the injection ports 70 are disposed on the surrounding side 220. When the passage of the spout 70 is ensured to be independent of the passage of the suction port 60, that is, the spout 70 and the suction port 60 are isolated from each other. The suction/discharge port 60 is located in the second working area 2102, that is, the suction/discharge port 60 is disposed on the outer end surface 210. Further, the injection port 70 and the suction port 60 are not in the same plane. The spout 70 is disposed close to the side of the steep region. During surgery, irrigation fluid flows out of the ports 70 disposed on the surrounding side 220. That is, the washing liquid is injected in a direction perpendicular to the nephroscope body 20, changes its direction by being blocked by the inner wall of the kidney K, is sucked by the suction device provided in the suction/discharge port 60, and is returned to the discharge passage 212 on the inner wall of the kidney to be discharged to the outside of the body. During the process, the kidney stone S fragments generated by the stone breaking device are washed through the most front end of the nephroscope main body 20, so that the turbid liquid in the kidney K is dispersed, and the visual field of the visual part 22 is expanded. In other words, a vortex is formed between the washing liquid from the injection port 70 toward the suction port 60, which is beneficial to disperse turbid liquid, avoid the visual line of the visible part 22 from being blurred, and entrain kidney stone S residues generated by the lithotripsy device to the discharge channel 212, and finally discharge the kidney stone S residues out of the body. The formation of vortex drives the promotion of circulation and stone efficiency of row, and the flush fluid can not be detained inside kidney K too much yet, has prevented that the inside pressure of kidney K is too big.

The instrument port 80 and the flush port 70 are located in the first working area 2101 with the lithotripsy instrument extending through the instrument port 80 a suitable length for lithotripsy procedures. The flushing port 70 is located adjacent the side of the calming section and covers the lithotripter as the flushing fluid is circulated in a vortex. In this process, the maximum extension of the lithotripsy instrument should not exceed the cross-sectional position of the circumferential side 220 closest to the innermost end of the urological scope 1. This prevents the region in which the flushing liquid is swirled from covering up to the region in which the rock breaking device is operated with precision when the flushing liquid is injected through the flushing port 70. That is, the washing liquid is prevented from being unable to be entrained and carrying away the crushed stones and being discharged from the suction/discharge port 60. Further, the working state of the lithotripter is always positioned in the visual field range of the visual part 22.

In the operation process of the mirror 1 for urinary surgery, the visible part 22 is preferably composed of an electronic mirror, and compared with the originally used optical fiber pixelized optical fiber conduction image information, the pixel points of the electronic mirror are higher, so that the transmitted picture is clearer, the stability of the operation is facilitated, and the safety of the operation is improved. One pixel point corresponds to one optical fiber line, that is, in the original optical fiber transmission, the radial length of the main lens tube 211 is limited due to the limitation of the radial length of the nephroscope body 20, and the radial length of the first working area 2101 is not too large, so that the channel of the visible part 22 is limited. Thus, the number of optical fibers disposed in the visible portion 22 is limited, so that the conducted image pixels are not high enough, and the image is blurred. The changed electron mirror can satisfy the characteristic of higher image quality than the optical fiber. And secondly, the electronic mirror occupies a small connecting space and only transmits electrons of the fibril lines.

The operation of the urological scope 1 for treating a kidney stone S in a kidney K is described by way of example.

The method comprises the following steps: as shown in fig. 5A, at a predetermined proper position, the operator inserts the puncture needle 2, grasping the lead 3, into the expanded renal position of the kidney K and close to the kidney stone S.

Step two: as shown in fig. 5B, the puncture needle 2 is removed, the lead 3 is retained in the body, and the punctured skin establishes a passage from the outside of the human body to the kidney K via the lead 3.

Step three: as shown in fig. 5C, the operator inserts the urological scope 1 into the kidney K along the passage established by the guide wire 3. Since the expanding sheath 10 and the nephroscope body 20 are shaped to facilitate puncturing, the proper depth of insertion is determined in cooperation with intermittent irradiation of X-rays during insertion and images transmitted by the visible part 22 provided on the outer end surface 210. The lithotripsy instrument is extended through the instrument port 80 a suitable length to perform a size reduction treatment on the kidney stone S. In the process of crushing the stones, the washing liquid injected into the injection port 70 cooperates with the inner wall of the kidney K and the suction of the suction device arranged at the suction port 60 to form a vortex circulation, so that the crushed stones generated by the operation of the stone crushing apparatus are washed and carried and discharged from the suction port to the outside. In the process of the eddy current washing, the turbid liquid in the kidney K is diluted, the visual field of the visual part 22 is recovered, and the condition of the crushed stone is judged.

Step four: and (4) finishing the operation of crushing the stone and recovering the crushed stone, and taking out the urology operation scope 1. The wound was sutured.

In summary, the urological endoscope 1 is illustrated, in which the urological endoscope 1 replaces the conventional percutaneous nephroscope, and the suction/discharge port 60 originally provided between the nephroscope main body 20 and the expanding sheath 10 is changed to the suction/discharge port 60 provided on the outer end surface 210. The original annular channel is changed into a channel with larger radial area. The flexibility of design with respect to the radial dimension of the suction and discharge port 60 is increased. The spatial layout of the outer end face 210 is optimized, and the blockage of the suction and discharge port 60 by the crushed kidney stones S is avoided.

Exemplary percutaneous nephroscope

As shown in fig. 1 to 5C, a mirror 1 for urinary surgery according to an embodiment of the present application is illustrated. The urological scope 1 can be used in procedures for treating kidney stones S by percutaneous nephrolithotomy. Specifically, the urological scope 1 is adapted to pass through the skin of a predetermined location of a patient to a target location of a kidney k for treatment of a kidney stone S (as shown in fig. 5C), and after the stone S within the kidney k is crushed, the crushed stone S can be expelled from the body through the urological scope 1.

For convenience of explanation, in the present embodiment, the end of the urological scope 1 inserted into the skin of the patient during the operation is the distal end of the urological scope 1, and the end opposite to the distal end of the urological scope 1 is the rear end.

In the present embodiment, the urological scope 1 includes: an introducer sheath 10 and an endoscope body 20 provided in the introducer sheath 10 are shown in fig. 1 and 2. The introducer sheath 10 has an introducer channel 11 extending through the introducer sheath 10, and the endoscope body 20 is disposed in the introducer channel 11 in the introducer sheath 10. The endoscope body 20 comprises an endoscope body 21 capable of being inserted into the skin of a patient, and the effective working length of the endoscope body 21 is greater than or equal to the length from the skin of a preset position of the patient to a target position of a kidney k. The total length of the mirror body 21 is greater than its effective working length.

The introducer sheath 10 includes an insertion section capable of being inserted into the kidney and an operation section connected to a rear end of the insertion section. The operation section comprises an operation main body, at least one holding piece and at least one standby operation piece, wherein the holding piece and the at least one standby operation piece are arranged on the operation main body. During operation, medical personnel can place fingers on the at least one holding piece so as to be convenient for the medical personnel to hold. Some surgical instruments may be coupled to the at least one redundant operator to facilitate functional manipulation (e.g., perfusion, suction of fluid, or debris) by medical personnel via the surgical instrument coupled to the at least one redundant operator. The insertion section may be detachably mounted to the operation section to facilitate replacement of the insertion section, or may be fixedly mounted to the operation section, which is not limited in this application.

The scope body 21 includes a main tube 211 and an exhaust passage 212 provided in the main tube 211, and the crushed stones S can be exhausted outside the body through the exhaust passage 212. Specifically, suction may be applied by a suction device in communication with the discharge channel 212, such that the channel cavity of the discharge channel 212 is under negative pressure, and the crushed stones S entering the discharge channel 212 are discharged outside the body. More specifically, the endoscope body 20 further includes a holding portion 23 disposed on the endoscope main body 21, and the holding portion 23 includes a housing, at least one auxiliary tube disposed in the housing, and at least one interface corresponding to the at least one auxiliary tube. The at least one auxiliary tube comprises a first auxiliary tube connected to the main tube 211, the first auxiliary tube having a first auxiliary channel connected to the discharge channel 212, the at least one port comprises a first port 231 connected to the first auxiliary channel, and the suction device can be connected to the discharge channel 212 through the first port 231 and the first auxiliary channel.

The at least one auxiliary tube may be integrally formed on the main tube 211 through a molding process, or may be combined with the main tube 211 through a welding process, etc., which is not limited in this application.

Preferably, the outer diameter of the mirror body 21 is smaller than or equal to the inner diameter of the guide channel 11, and the mirror body 21 is movably disposed in the guide channel 11. In a specific example of the present application, the mirror body 21 is movably disposed in the guide passage 11 in such a manner as to be telescopically disposed in the guide passage 11. During surgery, the scope body 21 may be removed from the introducer sheath 10 and other surgical instruments may be placed in the introducer sheath 10.

The guide channel 11 is arranged between the insertion section and the operating section. The guide channel 11 comprises a front guide opening 111 at the front end of the guide sheath 10 and a rear guide opening 112 at the rear end of the guide sheath 10, and a channel body 113 extending between the front guide opening 111 and the rear guide opening 112, the mirror body 21 being extendable through the front guide opening 111 and the rear guide opening 112, the mirror body 21 having a front end wall 210 and a peripheral wall 220 extending rearwardly around the outer periphery of the front end wall 210.

In one embodiment of the present application, the inner peripheral wall of the rear guide opening 112 has an internal thread, and the outer peripheral wall 220 of the mirror body 21 has an external thread corresponding to the internal thread, so that the mirror body 21 can be extended out of the front guide opening 111 or retracted into the guide passage 11 by rotating the inner mirror body 20. Because the thread is arranged between the rear guide opening 112 and the endoscope main body 21, a doctor can more stably control the extending length of the inner endoscope body 20, and the tissue and organ of a patient are prevented from being injured due to the overlong extending length of the inner endoscope body 20. It should be understood that the inner peripheral wall of the rear guide opening 112 and/or the outer peripheral wall 220 of the mirror body 21 can also be designed to have a thread-free structure, and the mirror body 21 can be extended out of the front guide opening 111 or retracted into the guide channel 11 by drawing the inner mirror body 20, which is not limited by the present application.

More preferably, when the mirror body 21 protrudes out of the front guide opening 111, there is no gap between the outer peripheral wall 220 of the mirror body 21 and the inner peripheral wall of the front guide opening 111, so as to avoid that the crushed stones S are difficult to be discharged out of the body by being caught in the gap between the outer peripheral wall 220 of the mirror body 21 and the inner peripheral wall of the front guide opening 11111, and this can provide the inner mirror body 20 with a sufficient radial dimension to more flexibly arrange the respective passages and openings, and other necessary structures or devices.

Accordingly, in one specific example of the present application, the cross-sectional shape of the outer peripheral wall 220 of the mirror body 21 coincides with the cross-sectional shape of the inner peripheral wall of the front guide opening 111, and the outer diameter of the mirror body 21 is equal to the inner diameter of the front guide opening 111. It should be noted that the outer diameter of the mirror body 21 and the inner diameter of the front guide opening 111 are inevitably different from each other in the inner diameter of the front guide opening 111. Therefore, the outer diameter of the mirror body 21 being equal to the inner diameter of the front guide opening 111 and the inner diameter of the front guide opening 111 means that the outer diameter of the mirror body 21 being equal to the inner diameter of the front guide opening 111, including the outer diameter of the mirror body 21 being equal to the inner diameter of the front guide opening 111, and the outer diameter of the mirror body 21 being slightly smaller than the inner diameter of the front guide opening 111 to ensure that the mirror body 21 can pass through the front guide opening 111.

In one embodiment, the clearance between the outer peripheral wall 220 of the mirror body 21 and the inner peripheral wall of the front guide opening 111 is less than a preset value of 0.5 mm, i.e., the clearance between the outer peripheral wall 220 of the mirror body 21 and the inner peripheral wall of the front guide opening 111 is less than 0.5 mm.

The channel body 113 of the guide channel 11 may be bonded to the mirror body 21, or may have a gap with the mirror body 21. Accordingly, in a specific example of the present application, the cross-sectional shape of the outer peripheral wall 220 of the mirror body 21 coincides with the cross-sectional shape of the inner peripheral wall of the channel body 113, and the inner diameter of the channel body 113 of the guide channel 11 is equal to the outer diameter of the mirror body 21, and the channel body 113 of the guide channel 11 can be fitted to the mirror body 21. In another specific example of the present application, the inner diameter of the channel body 113 of the guide channel 11 is smaller than the mirror body, i.e., there is a gap between the inner peripheral wall of the channel body 113 of the guide channel 11 and the mirror body 21. Also, in a specific embodiment in this specific example, the peripheral wall of the guide sheath 10 has a conduction opening communicating with the channel body 113, and the gap between the inner peripheral wall of the channel body 113 of the guide channel 11 and the mirror body 21 allows the perfusate to pass therethrough and exit from the conduction opening, that is, the gap between the inner peripheral wall of the channel body 113 of the guide channel 11 and the mirror body 21 can be used as a perfusion channel, and the conduction opening can be used as a perfusion port.

It should be noted that, in the embodiments of the present application, the inner diameter or the outer diameter refers to an equivalent circular diameter. That is, when the shape of the cross section of the structure is a circle, the diameter of the structure is the diameter of the corresponding circle, and when the shape of the cross section of the structure is a non-circle, the diameter of the structure is the diameter of a circle having the same area as the area of the cross section of the structure. The cross-section of the structure refers to: a common area (or non-empty intersection) of the structure and a face perpendicular to the axial direction in which the structure is set.

During the operation of using the urological scope 1 for lithotomy to treat the kidney stone S, the endoscope body 20 needs to reserve space for some surgical instruments (e.g., lithotripsy optical fiber, guide wire 3) and other necessary structures or devices, for example, in some embodiments of the present application, a channel for allowing perfusion fluid to pass through, a channel for allowing lithotripsy optical fiber to pass through, an image acquisition device 22, and the like are provided. Taking the image collecting device 22 as an example for illustration, in the process of using the urology operation scope 1 to remove the calculus to treat the kidney calculus S, the extending length of the endoscope body 20 should be suitable, when the endoscope body 20 enters the kidney k deeply, the endoscope body may enter the renal vein or even the vena cava by mistake, and further cause heavy bleeding. Accordingly, as shown in fig. 3A and 3B, the endoscope body 20 further includes an image capturing device 22 disposed on the endoscope main body 21, so that the position reached by the urological endoscope 1 can be monitored in real time, and the operation safety can be improved.

It is worth mentioning that in the present embodiment, under the condition that the radial space of the endoscope body 20 is limited, the remaining radial space can be used for arranging the discharge channel 212 for discharging the crushed stones S, while the necessary radial space is reserved for necessary structures and devices. In order to leave more space (mainly radial space), the necessary structures and devices can be concentrated in a specific area, which can theoretically be designed in any area of the mirror body 21, and the remaining area can be provided for the discharge channels 212. However, the inventors of the present application have found that when the specific region is provided in a region away from the outer peripheral edge of the front end wall 210 of the mirror body 21 in the radial direction in which the mirror body 21 is set, and the remaining region surrounding the specific region is used for laying out the discharge passage 212, the remaining region will be difficult to be utilized sufficiently to exert its effect.

For example, when the specific region is provided in the central region of the mirror body 21 and the distances between the respective portions of the outer periphery of the specific region and the outer periphery of the mirror body 21 are equal, the remaining region is an annular region surrounding the central region, and the discharge passage provided in the remaining region may be designed as an annular passage or a semi-annular passage. The radial dimension of the remaining area is equal to the difference between the radial dimension of the specific area and the radial dimension of the mirror body 21, however, the size of stones allowed to pass through the annular channel is less than or equal to half the difference between the radial dimension of the specific area and the radial dimension of the mirror body 21, i.e. less than or equal to half the radial dimension of the remaining area, and stones of larger size are prone to clogging when passing through. Furthermore, a full circle of the inner wall of the annular channel protrudes towards the outer wall of the annular channel, which is not conducive to the passage of crushed stones. Of course, the discharge channel provided in the remaining region may be designed as a plurality of circular channels surrounding the remaining region, however, the radial dimension of the circular channel is also less than or equal to half of the difference between the radial dimension of the specific region and the radial dimension of the mirror body 21, and stones with larger dimensions are likely to be clogged when passing through the channel. Thus, the radial space of this remaining area is difficult to be fully utilized.

When the specific area is provided in an area adjacent to the outer periphery of the front end wall 210 of the mirror main body 21 in the radial direction set by the mirror main body 21, the space utilization of the remaining area is relatively high as compared with an area where the specific area is provided away from the outer periphery of the front end wall 210 of the mirror main body 21 in the radial direction set by the mirror main body 21. Specifically, when the specific area is provided in an area adjacent to the outer periphery of the front end wall 210 of the mirror body 21 in the radial direction set by the mirror body 21, the remaining area around the specific area is wrapped around only the outer periphery of a portion of the specific area, and the exhaust passage may be provided between the outer periphery of the portion of the specific area and the outer periphery of the front end wall 210 in the radial direction set by the mirror body 21. The radial dimension of the specific area is still equal to the difference between the radial dimension of the specific area and the radial dimension of the mirror body 21, while the radial dimension of the evacuation channel may be equal to or slightly smaller than the difference between the radial dimension of the specific area and the radial dimension of the mirror body 21, so that the utilization of the remaining space is relatively high.

Accordingly, in the present embodiment, the mirror body 21 has the outer peripheral wall concentrated arrangement region adjacent thereto and a dedicated arrangement region located around the concentrated arrangement region. The image capturing device 22 is located in the centralized placement area and the discharge passage 212 is located in the dedicated placement area. Said front end wall 210 comprises a reserved concentration area 2101 at a corner adjacent to its outer periphery and a free dedicated area 2102 located around said reserved concentration area 2101, preferably at least a part of said reserved concentration area 2101 shares an outer periphery with said front end wall 210. The image capturing device 22 is mounted in a reserved concentration area 2101 of the front end wall 210, and preferably, the front end of the urological scope 1 is within the field of view of the image capturing device 22. The discharge passage 212 has a discharge port 60 formed in the front end wall 210, and the discharge port 60 is provided in the vacant dedicated area 2102.

Preferably, the shape of the orthographic projection of the discharge port 60 in the axial direction set by the mirror main body 21 is crescent-shaped, as shown in fig. 3B. It is further preferable that the cross-sectional shape of the portion of the discharge passage 212 adjacent to the discharge port 60 coincides with the shape of the orthographic projection of the discharge port 60 in the axial direction set by the mirror body 21, being crescent-shaped. The cross-sectional shape of the portion of the discharge passage 212 that is farther from the discharge port 60 may or may not coincide with the shape of the orthographic projection of the discharge port 60 in the axial direction set by the mirror body 21, for example, the cross-sectional shape of the rear end portion of the discharge passage 212 may be circular, which is not a limitation of the present application.

Here, the axial direction in which the mirror main body 21 is set is: in the forward direction along the central axis of the mirror body 21. Accordingly, the radial direction in which the mirror main body 21 is set means a direction perpendicular to the axial direction in which the mirror main body 21 is set. The orthographic projection of the discharge port 60 in the axial direction set by the mirror main body 21 means: when the light irradiates the discharge port 60 in the axial direction set by the mirror body 21, the discharge port 60 is orthographically projected on a plane perpendicular to the center axis of the mirror body 21.

In some embodiments of the present application, the inner diameter of the discharge passage 212 is equal to or greater than one-half of the inner diameter of the main tube 211, and the area of the discharge port 60 is equal to or greater than one-half of the area of the front end wall 210, so as to prevent the crushed stones S from being blocked in the discharge port 60, thereby ensuring a space for discharging the stones S.

It is worth mentioning that the image capturing device 22 is adapted to be communicatively connected to an image output device (e.g., an image display) so that medical personnel can observe the condition of the urological scope 1 and the kidney k through the image output device. The image capturing device 22 includes at least one camera, preferably having a field of view that covers a substantial portion of the front end wall 210 of the urology scope 1.

Further, the discharge port 60 is located within the field of view of the image capturing device 22, so that the state of the discharge port 60 can be observed in real time to improve the stone discharge efficiency and the safety of the operation. For example, when the discharge port 60 is observed to be clogged, the calculi S clogged in the discharge port 60 can be removed in time, or the injection of the perfusate and the aspiration of the fluid and the crushed calculi S can be stopped in time to maintain the balance of the internal pressure of the kidney k.

In order to allow the discharge opening 60 to be located within the range of the field of view of the image pickup device 22, the image pickup device 22 may be located behind the discharge opening 60, where the fact that the image pickup device 22 may be located behind the discharge opening 60 means that the front end point of the light receiving surface of the image pickup device 22 that receives light reflected by an object is located behind the rear end point of the discharge opening 60. Accordingly, the vacant dedicated area 2102 of the front end wall 210 may be located behind the image pickup device 22. Also, preferably, the discharge port 60 and the image pickup device 22 are close to each other from the rear to the front so that the discharge port 60 is within the field of view of the image pickup device 22, and accordingly, the image pickup device 22 and/or the discharge port 60 may be disposed obliquely with respect to a plane perpendicular to the axial direction set by the mirror body 10.

Further, the discharge port 60 may extend on a plane perpendicular to the axial direction set by the mirror body 21, or may extend obliquely with respect to a plane perpendicular to the axial direction set by the mirror body 10. Accordingly, the free exclusive area 2102 of the front end wall 210 may extend on a plane perpendicular to the axial direction set by the mirror main body 21, or may extend obliquely with respect to the plane perpendicular to the axial direction set by the mirror main body 10.

In a specific example of the present application, the free dedicated area 2102 of the front end wall 210 is perpendicular to the central axis of the mirror body 21. The light receiving surface of the image pickup device 22 is located rearward of the discharge opening 60, and is provided at a reserved concentration region 2101 of the front end wall 210 obliquely with respect to a plane perpendicular to the axial direction set by the mirror body 10 toward the discharge opening 60 so that at least a part of the discharge opening 60 is within the range of view of the image pickup device 22.

In another specific example of the present application, the free dedicated region 2102 of the front end wall 210 extends obliquely with respect to a plane perpendicular to the axial direction set by the mirror body 10, as shown in fig. 3A. The free dedicated area 2102 of the front end wall 210 extends obliquely forward in a preset extending direction from a first side thereof adjacent to the reserved concentration area 2101 to a second side opposite to the first side. The image pickup device 22 is located behind the vacant exclusive area 2102 and is provided in the reserved concentration area 2101 of the front end wall 210 obliquely with respect to a plane perpendicular to the axial direction set by the mirror body 10 toward the discharge port 60 so that at least a part of the discharge port 60 is within the field of view of the image pickup device 22.

It is to be understood that the larger the inclination degree of the vacant dedicated area 2102, that is, the smaller the angle between the central axis of the mirror main body 21, the steeper the vacant dedicated area 2102, the closer the discharge port 60 is to the image pickup device 22 in the radial direction set by the mirror main body 21, and the higher the possibility that the image pickup device 22 can photograph the discharge port 60.

In this particular example, the vacant dedicated area 2102 includes a steep area extending obliquely forward from a first side thereof adjacent to the reserved concentrated area 2101 to a second side thereof remote from the reserved concentrated area 2101 and a flat area extending from the steep area to the second side thereof remote from the reserved concentrated area 2101, at least a portion of the exhaust 60 is located in the steep area, and the exhaust 60 may include a steep section corresponding to the steep area and a flat section corresponding to the flat area. Alternatively, the discharge opening 60 may be located entirely in the steep area so that the image capture device 22 can capture the entire discharge opening 60 and its vicinity as far as possible, or may be located partially in the steep area. In an embodiment of this specific example, an angle between the preset extending direction and an axial direction set by the mirror main body 21 is smaller than half of an angle of field of a camera of the image pickup apparatus 22.

Further, in this specific example, the angle between the preset extending direction (i.e., the extending direction of the free dedicated region 2102 of the front end wall 210) and the axial direction set by the mirror main body 21 decreases first and then increases from the first side to the second side of the free dedicated region 2102. Accordingly, the included angle between the preset extending direction of the steep-slope region and the axial direction set by the mirror main body 21 gradually decreases from the first side of the vacant dedicated region 2102 to the gentle region, becomes steeper and shallower, and is locally recessed inward, so as to prevent the vacant dedicated region 2102 of the front end wall 210 from protruding and blocking the light reflected toward the image capturing device 22. That is, at least a portion of the steep area of the vacant dedicated area 2102 is depressed inward.

It is worth mentioning that, in this specific example, the front end wall 210 extends obliquely from a first side adjacent to the image capturing device 22 to a second side opposite to the first side, and the inclination of the second side peripheral portion adjacent to the second side (i.e., the angle between the front end wall 210 and the plane perpendicular to the axial direction set by the mirror body 21) is low, so as to prevent the second side peripheral portion located in front of the first side peripheral portion of the front end wall 210 from damaging the organ tissue of the patient due to being too sharp, which can improve the safety of the operation.

In other specific examples, the front end point of the light receiving surface of the image capturing device 22 may be flush with the rear end point of the discharge port 60. Further, it may be designed that either one of the image pickup device 22 and the vacant region 2102 of the front end wall 210 is disposed obliquely to a plane perpendicular to the axial direction set by the mirror main body 21, or it may be designed that both the image pickup device 22 and the vacant region 2102 of the front end wall 210 are disposed obliquely to a plane perpendicular to the axial direction set by the mirror main body 21.

In the embodiment of the present application, the scope main body 21 further includes an injection passage provided to the main tube 211, and the injection passage has an injection port 70 located at a front end portion of the scope main body 21. The infusion channel is adapted to communicate with an infusion device to allow the infusion fluid to pass through and be injected into the kidney k, the infusion fluid exiting the infusion port 70 may impact the crushed stone S, bounce off when encountering the inner wall of the renal pelvis or other body, entrain the crushed stone S when reaching the vicinity of the exit port 60, enter the exit port 60, and be expelled from the body through the exit channel 212 communicating with the exit port 60.

It should be noted that, as mentioned above, when there is a gap between the inner peripheral wall of the channel body 113 of the guide channel 11 and the mirror body 21, and the peripheral wall of the guide sheath 10 has the conducting opening communicating with the channel body 113, the gap between the inner peripheral wall of the channel body 113 of the guide channel 11 and the mirror body 21 can be used as a flow injection channel, and the conducting opening can be used as a flow injection port.

Correspondingly, the at least one auxiliary tube comprises a second auxiliary tube connected to the main tube 211, the second auxiliary tube has a second auxiliary channel connected to the injection channel, the at least one interface comprises a second interface 232 (not shown) connected to the second auxiliary channel, and the perfusion apparatus can be connected to the injection channel through the second interface 232 and the second auxiliary channel.

The injection port 70 may be provided in the front end wall 210 of the mirror body 21 or the outer peripheral wall 220. In a specific example of the present application, the injection port 70 is disposed in the reserved concentration area 2101 of the front end wall 210, as shown in fig. 4. Preferably, when the spout 70 is disposed at the reserved concentration area 2101 of the front end wall 210, the spout 70 is disposed at a position adjacent to the image pickup device 22, that is, the spout 70 is adjacent to the image pickup device 22, so that the spout 70 and the image pickup device 22 are compactly disposed at the reserved concentration area 2101, the radial size occupied by the reserved concentration area 2101 is reduced, and the radial size of the vacant dedicated area 2102 is relatively increased.

In another specific example of the present application, the flow port 70 is provided at a front end of the outer peripheral wall 220 adjacent to the discharge port 60 in the axial direction set by the mirror body 21. When the flow ports 70 are provided in the outer peripheral wall 220, the flow ports 70 mainly occupy a space in the axial direction of the mirror body 21, so that a radial space of the mirror body 21 can be saved for the arrangement of the discharge ports 60, and the design of the structural features such as the size, shape, number, and the like of the flow ports 70 and the discharge ports 60 is more flexible.

The shape, size and number of the orifices 70 are not intended to be limiting. For example, the injection ports 70 may be designed to be semi-circular, drop-shaped, circular, etc., the size of the injection ports 70 may be designed according to the actual application requirements, and the number of the injection ports 70 may be 1,2, or other values.

In the embodiment of the present application, the scope main body 21 further includes a first working channel for allowing a working component (e.g., a lithotripsy optical fiber, a guide wire 3, and other surgical instruments) to pass through, and the first working channel is disposed on the main tube body 211, can be isolated from other channels to avoid mutual interference between the channels, and can also be communicated with other channels, which is not limited in the present application.

Accordingly, in one specific example of the present application, the mirror body 21 further includes a first working channel communicating with the discharge port 60. The endoscope body 20 further comprises at least one working component telescopically arranged in the first working channel, the head of the at least one working component is suitable for extending out of the discharge port 60, so that the head of the at least one working component is within the field of view of the image acquisition device 22 when extending out of the discharge port 60, and the at least one working component comprises the lithotripsy optical fiber.

In another specific example of the present application, the mirror body 21 further includes a first working channel disposed on the main tube body 211, and the front end wall 210 is provided with a first working opening 80 communicated with the first working channel, as shown in fig. 4. Preferably, the first working opening 80 is within the field of view of the image capture device 20. When the first working opening 80 is located in the reserved concentration area 2101 of the front end wall, preferably, the first working opening 80 is arranged at a position adjacent to the image capturing apparatus 22, that is, the first working opening 80 is adjacent to the image capturing apparatus 22, so that the first working opening 80 and the image capturing apparatus 22 are compactly arranged in the reserved concentration area 2101, the radial size occupied by the reserved concentration area 2101 is reduced, and the radial size of the vacant dedicated area 2102 is relatively increased. The discharge port 60 may be used as the first working opening 80, and specifically, as described above, the first working channel communicates with the discharge port 60 of the discharge channel 212, in such a manner that the discharge port 60 is used as the first working opening 80.

The endoscope body 20 further comprises at least one working component telescopically disposed in the first working channel, a head of the at least one working component is adapted to extend out of the first working opening 80, and the head of the at least one working component is within a field of view of the image capturing device 22 when extending out of the first working opening 80.

Correspondingly, the at least one auxiliary pipe body includes a third auxiliary pipe body connected to the main pipe body 211, the third auxiliary pipe body has a third auxiliary channel communicated with the first working channel, the at least one interface includes a third interface 233 communicated with the third auxiliary channel, and the working component can enter the first working channel through the third interface 233.

It will be appreciated by those skilled in the art that the working member may be disposed in other channels, for example, the guide wire 3 may pass through the injection port 70 and the injection channel or the discharge port 60 and the discharge channel 212 to guide the urology scope 1 into the kidney k, and the guide wire 3 may be drawn out of the injection channel after guiding the urology scope 1 into the kidney k, so as not to affect the output of the perfusate or the output of the stones S, or affect the passage of other working members. For another example, the lithotripsy fiber may be movably disposed in the discharge passage 212 and extend from the discharge port 60.

The operation of treating a renal stone S by percutaneous nephrolithotomy using the urological endoscope 1 will be described below.

Step 1: the urological scope 1 is placed into the kidney collecting system. Specifically, first, a lithotomy channel is established between the patient's skin and the kidney assembly system. An incision (about 0.5 mm) can be made in the skin of the patient at a predetermined location and the renal k can be punctured by the puncture needle 2 under the guidance of an X-ray machine or a B-ultrasonic machine to establish the lithotomy channel, as shown in fig. 5A. It should be noted that the depth of the puncture is crucial for the operation, and when the depth of the puncture is shallow, the puncture needle 2 may only enter the renal parenchyma and not reach the renal collecting system, not only the purpose of treating the kidney stone S is not achieved, but also the renal hemorrhage may be caused; when the puncture depth is deep, the puncture needle 2 may be mistakenly inserted into the renal vein or even the vena cava, which may cause a large bleeding.

Next, guidewire 3 is placed into the kidney assembly system, as shown in fig. 5B. Specifically, the puncture needle 2 comprises a needle sheath and a needle core movably arranged on the needle sheath, and after the puncture needle 2 punctures the kidney k and enters the kidney collection system, the needle core can be withdrawn and a guide wire 3 can be inserted into the needle sheath so that the guide wire 3 is arranged in the kidney collection system along the needle sheath.

Then, the urological scope 1 is placed to the target position of the kidney k, as shown in fig. 5C. Specifically, the urological scope 1 is inserted into the kidney assembly system along the guide wire 3, and the guide wire 3 can be withdrawn after the urological scope 1 enters the target position of the kidney k.

In some embodiments of the present application, the introducer sheath 10 of the urological scope 1 and the dilation tube disposed within the introducer sheath 10 may be first inserted into the renal congregation system along the guidewire 3, and the guidewire 3 may be passed through the operative channel of the dilation tube such that the introducer sheath 10 and the dilation tube may be advanced along the guidewire 3 into the renal congregation system. The insertion end of the dilating tube inserted into the kidney assembly system has a tapered structure from back to front, that is, the front end of the insertion end of the dilating tube has a small size, and can easily pass through the skin of a patient and enter the kidney assembly system, then the dilating tube in the urinary surgery scope 1 is withdrawn, and the endoscope body 20 of the urinary surgery scope 1 is inserted into the guide sheath 10 until the scope body 21 of the endoscope body 20 reaches the target position of the kidney k.

In other embodiments of the present application, the introducer sheath 10 of the urological scope 1 and the endoscope body 20 disposed in the introducer sheath 10 are directly inserted into the target position of the kidney k along the guide wire 3, and the guide wire 3 can pass through the discharge channel 212 or the injection channel of the endoscope body 20, or the first working channel, so that the introducer sheath 10 and the endoscope body 20 can enter the target position of the kidney k along the guide wire 3. Preferably, the front end of the mirror body 21 has a tapered structure from back to front, which can easily penetrate through the skin of the patient and enter the kidney assembly system, and an image capturing device 22 adapted to be communicably connected to an image output device is provided on the mirror body 21 to capture images of the mirror body 21 and the tissues around the mirror body 21, so that medical staff can observe the condition of the mirror body 21 and the kidney k through the image output device.

And 2, step: the kidney stones S are crushed by a stone crushing device. In particular, a lithotripsy device may enter the first working channel of the urology scope 1 through its third port 233, which communicates with the first working channel, and exit the first working opening 80 or the exit port 60 to hit the kidney stone S. The lithotripsy apparatus may be implemented as a pneumatic ballistic lithotripter, a holmium laser, an ultrasonic lithotripter, etc., and is not limited in this application.

And step 3: the crushed stones S are discharged to the outside of the body through the discharge passage 212 of the urological scope 1. Specifically, during the breaking up of the kidney stones S by the lithotripsy apparatus, the kidneys k may be perfused with a perfusate that may exit a spout 70 in communication with the fluid passageway to impact the broken up stones S. As shown in fig. 5C, the perfusate bounces back when it encounters the inner wall of the renal pelvis or other body, and upon reaching the vicinity of the discharge port 60, entrains the crushed stones S into the discharge port 60 and is discharged from the body through the discharge passage 212 communicating with the discharge port 60. During the process of crushing the kidney stones S by the stone crushing device, the suction device communicated with the discharge channel 212 can also perform suction, so that the channel cavity of the discharge channel 212 is in a negative pressure state, and the crushed stones S entering the discharge channel 212 are discharged out of the body.

In summary, a urological scope 1 according to an embodiment of the present application is illustrated, wherein the urological scope 1 relatively increases the design flexibility of the radial dimension of the inner scope body 20 by reducing the gap between its introducer sheath 10 and the inner scope body 20 disposed within the introducer sheath 10, so as to relatively increase the space of the discharge channel for discharging stones disposed in the inner scope body 20. Moreover, the urological scope 1 increases the space for guiding out the crushed stones S relatively by designing the spatial arrangement and the structural characteristics of the discharge channel 212, so as to avoid blocking of the crushed stones S as much as possible.

It will be appreciated by persons skilled in the art that the embodiments of the invention described above and shown in the drawings are given by way of example only and are not limiting of the invention. The objects of the invention have been fully and effectively accomplished. The functional and structural principles of the present invention have been shown and described in the embodiments, and any variations or modifications may be made to the embodiments of the present invention without departing from the principles described.

Claims

1. A urology scope comprising:

an expanding sheath; and

a nephroscope main part, wherein extend sheath detachably cup joint in the nephroscope main part, the nephroscope main part includes a main mirror body and a visual portion, wherein the main mirror body includes a first workspace and a second workspace, first workspace encircle in the second workspace, visual portion is located first workspace, the main mirror body sets up suction and discharge mouth and a rush stream mouth, suction and discharge mouth with the rush stream mouth is located respectively the second workspace with first workspace, the main mirror body has a discharge passage and an injection passage of mutual independence, wherein the discharge passage communicate in the suction and discharge mouth, the injection passage communicate in the rush stream mouth, the flush fluid certainly turn back in the kidney inner wall after the rush stream mouth flows back the suction and discharge mouth forms vortex circulation in order to be discharged in vitro.

2. A urological scope as claimed in claim 1, wherein the main body has a peripheral side extending axially rearward of the main body from the outer edge of the first working area, wherein the flushing port is provided in the peripheral side.

3. A mirror for urinary surgery according to claim 2, wherein the suction/discharge port is disposed at a front end of the visible portion and keeps the suction/discharge port within a visual field of the visible portion.

4. A urological scope as claimed in claim 3, wherein the suction port diameter is greater than the irrigation port diameter.

5. A urological scope as claimed in claim 2, wherein the main scope body includes an outer end face, the outer end face is provided with an instrument port, the instrument port is located in the first working area in a manner separated from the flushing port and the visible portion, and the instrument port is located in the visual field of the visible portion, so that a lithotripsy instrument can extend to the lesion site through the instrument port to complete lithotripsy under the visible state.

6. A urological scope according to claim 5, wherein the flush port is provided to the outer end face such that the flush port is located at an end of the nephroscope body.

7. A urinary surgical scope as claimed in claim 5, wherein the outer end surface has an abrupt area and a gradual area, the abrupt area being connected to the gradual area, the visible area being located in the gradual area, the suction and discharge port being located in the abrupt area, and the flush port being located adjacent to the gradual area.

8. A urological mirror as claimed in claim 7, wherein the plane of the abrupt section intersects the plane of the gradual section at an angle, the plane of the gradual section being parallel to the radial plane of the main mirror.

9. A mirror for urinary surgery as claimed in claim 8, wherein the main mirror body is tapered from a rear end to a front end, the main mirror body being of decreasing radial cross-section.

10. A urological scope as claimed in any one of claims 2 to 9, wherein the dilating sheath has an inner side adapted to abut the surrounding side and an outer side adapted to abut a puncture needle and skin forming a channel to support the main scope body.

11. A urological scope, comprising:

an expanding sheath; and

a nephroscope main part, wherein expand sheath detachably cup joint in the nephroscope main part, the nephroscope main part includes a main mirror body and a visual portion, wherein the main mirror body includes a first workspace and a second workspace, first workspace encircle in the second workspace, visual portion is located first workspace, the main mirror body sets up one and inhales row of mouth and a rush current mouth, inhale row of mouth with the rush current mouth is located respectively the second workspace with first workspace, the main mirror body has a discharge channel and an injection channel of mutual independence, wherein discharge channel communicate in inhale row of mouth, injection channel communicate in rush current mouth, flush fluid from after rush current mouth flows back in the kidney inner wall turns back to inhale row of mouth, form the vortex circulation in order to be discharged outside, wherein expand the sheath and have one and expand the chamber, expand the chamber and be suitable for and place the main mirror body.

12. A urological scope as claimed in claim 11, wherein the visualization portion communicates with an image transmitting device adapted to convert images.

13. A mirror for urinary surgery according to claim 11, wherein a shape of an orthographic projection of the suction/discharge port along the axial direction of the main mirror body is a crescent.

14. A mirror for urinary surgery as claimed in claim 13, wherein the nephroscope body further includes an operation portion connected to the tail end of the main mirror body for controlling the main mirror body to perform corresponding operations.

15. A urological scope as claimed in claim 11, wherein the expanding sheath has an inner side adapted to abut the surrounding side and an outer side adapted to abut a puncture needle and skin forming a channel to support the main scope body.