CN115886996A - Near-far double-click ureteroscope and method for removing calculus by using ureteroscope - Google Patents

Abstract

A proximal-distal double strike ureteroscope and a method for removing a calculus using the ureteroscope are disclosed, wherein the proximal-distal double strike ureteroscope includes an operating portion, a scope body having a front end portion and a rear end portion, a first striking mechanism, and a second striking mechanism. The first stone striking mechanism can be used for striking stones in the kidney, and the second stone striking mechanism can be used for striking stones blocked at the suction port. In this way, the distal-proximal double-strike ureteroscope can realize the following by adopting a scheme of 'distal-proximal double-strike': when the stones embedded in the kidney or the movable stones are hit, the stones blocked at the suction port of the suction channel are cleaned, so that the stone removing efficiency is improved.

Description

Near-far double-click ureteroscope and method for removing calculus by using ureteroscope

Technical Field

The application relates to the field of medical equipment, in particular to a far-near double-click ureteroscope and a method for removing calculus by using the ureteroscope.

Background

In recent years, ureteroscopes have been widely used for the treatment of urinary calculus diseases. Specifically, the ureteroscope can extend into the ureter or the kidney from the urethral orifice, and medical workers can observe the condition in the kidney and break stones at the target position by using the ureteroscope and matching with equipment such as image acquisition equipment and lighting equipment.

In practical application, in the process of beating the calculus through the ureteroscope, when the size of the calculus is large, the calculus is difficult to be powdered after being smashed to the equivalent diameter of about 2mm by the traditional ureteroscope. Furthermore, the crushed stones with larger diameters are difficult to be led out of the body of the patient through an effective leading-out mechanism. After the calculus is smashed by the traditional ureteroscope, 60% -90% of the calculus is remained in the kidney and is difficult to be discharged out of the body in time by a natural discharging mode, and the calculus residue is one of the main reasons for high calculus recurrence rate.

To address this problem, ureteroscopy designs are proposed that are capable of removing the debris. In this design, the ureteroscope is provided with an evacuation mechanism to evacuate the crushed stones out of the body in time. However, in practical application, the crushed stones are easy to be blocked in the discharge mechanism of the ureteroscope, the stone removal efficiency is low, and the operation time is long.

Therefore, a new stone removal solution is needed to improve stone removal efficiency.

Disclosure of Invention

An advantage of the present application is to provide a proximal-distal double strike ureteroscope and a method for removing stones using the ureteroscope, wherein the proximal-distal double strike ureteroscope can be implemented by adopting a "distal-proximal double strike" scheme: when the calculus embedded in the kidney or the movable calculus is hit, the calculus blocked at the suction port is cleaned, and the calculus removing efficiency is further improved.

Another advantage of the present application is to provide a near-far double-click ureteroscope and a method for removing stones by using the ureteroscope, wherein the near-far double-click ureteroscope can further hit stones blocked at a suction port by using the blocking effect of the suction port on crushed stones, so that stones blocked at the suction port can be quickly crushed and then discharged through the suction port, thereby improving stone derivation efficiency and stone removal efficiency.

To achieve at least one of the advantages described above, according to one aspect of the present application, there is provided a proximal-distal double tap ureteroscope comprising:

an operation section;

a tube lens body having a front end and a rear end, comprising: a tube structure body, at least one irrigation channel extending within the tube structure body from the rear end to the front end, a suction channel within the tube structure body extending from the front end to the rear end, the suction channel having a suction port at the front end, the operating portion being operatively connected to the tube scope body;

a first stone striking mechanism comprising: the first head part is protruded out of the front end part of the tube lens main body and is used for hitting stones; and

a second stone striking mechanism comprising: the second head part of the second stone striking mechanism is positioned at the suction port of the suction channel and is used for striking stones blocked at the suction port.

In the proximal-distal double-strike ureteroscope according to the present application, the first head portion of the first striking mechanism is located forward of the second head portion of the second striking mechanism.

In a proximal-distal double click ureteroscope according to the present application, the orientation of the first head is a first orientation, the orientation of the second head is a second orientation, the first orientation and the second orientation form a preset angle, and the preset angle is greater than 0 ° and smaller than 180 °.

In the proximal-distal double-strike ureteroscope according to the present application, the first head of the first striking mechanism is not located on the laser emission path of the second striking mechanism.

In the proximal-distal double strike ureteroscope according to the present application, the scope body has a leading end surface and an outer peripheral surface, the leading end surface extends obliquely forward from a first side of the outer peripheral surface to a second side opposite to the first side in an axial direction set by the scope body.

In the ureteroscope according to the present application, the first head portion extends from the distal end surface, and any point on the distal end surface is not located on the laser emission path of the first stone hitting mechanism and the second stone hitting mechanism.

In a proximal-distal double click ureteroscope according to the present application, the first head is movably disposed at the front end portion to switch between a first state and a second state, wherein when in the first state, the first head extends from the front end portion to a first position, and when in the second state, the first head extends from the front end portion to a second position, and a distance between the first position and the front end portion is greater than a distance between the second position and the front end portion.

In the near-far double-hit ureteroscope according to the present application, the ureteroscope further includes a first optical fiber channel disposed in the ureteroscope main body, the first hit stone mechanism is telescopically disposed in the first optical fiber channel, the first optical fiber channel has a first stone breaking port formed at the front end portion, and the first head portion is disposed in the first optical fiber channel and extends out from the first stone breaking port.

In far and near double-click formula ureteroscope according to this application, second head movably set up in attract the passageway to switch between third state and fourth state, when being in the third state, the second head stretches out attract mouthful for hit the calculus, when being in the fourth state, the second head retract to attract mouthful for hit the calculus that blocks up in attract mouthful.

In far and near double stroke formula ureteroscope according to this application, the scope main part further including communicate in attract the second fibre channel of passageway, the second hits stone mechanism telescopically set up in second fibre channel, second fibre channel include the main part section with extend in the main part section with attract the intercommunication section between the passageway, the intercommunication section intercommunication attract the passageway with the main part section, the second head passes through the intercommunication section stretch into to attract the passageway.

In the ureteroscope according to the present application, the tube structure main body has a front end surface at which the suction port is formed and an outer peripheral surface, wherein the front end surface extends obliquely forward from a first side of the outer peripheral surface to a second side opposite to the first side in an axial direction set by the scope main body.

In the proximal-distal double-strike ureteroscope according to the application, the included angle between the central axis of the communicating section and the central axis of the suction channel ranges from 0 degrees to 45 degrees.

In the proximal-distal double-strike ureteroscope according to the present application, when the second striking mechanism is in the fourth state, the second striking mechanism is located in a middle region of the suction port.

In the proximal-distal double-strike ureteroscope according to the present application, when the second strike mechanism is in the fourth state, the leading end of the second head is flush with the leading end face.

In the far and near double-strike ureteroscope according to this application, far and near double-strike ureteroscope further includes set up in the third stone mechanism of beating of scope main part includes: a third head portion and a third body portion extending rearward from the third head portion, the third head portion of the third stone striking mechanism.

In a proximal-distal double click ureteroscope according to the present application, the perfusion channel has a perfusion port at the front end portion, the perfusion port of the perfusion channel has a first orientation for allowing fluid to be injected into the renal pelvis from the perfusion port along the perfusion channel in a first direction directed in the first orientation, and the suction port of the suction channel has a second orientation at a preset angle to the first orientation for allowing the fluid to be sucked from the suction port into the suction channel in a second direction directed in the second orientation after being diverted within the renal pelvis to form a fluid loop.

According to another aspect of the present application, there is also provided a method of removing stones with a ureteroscope, comprising:

the laser emitted by the first stone hitting mechanism hits the stone;

leading the crushed stones to a suction port of the suction channel through the fluid return ring; and

the laser emitted by the second stone striking mechanism strikes the stones blocked at the suction port, so that the stones blocked at the suction port can be broken and then discharged through the suction port.

Further objects and advantages of the present application will become apparent from an understanding of the ensuing description and drawings.

These and other objects, features and advantages of the present application will become more fully apparent from the following detailed description, the accompanying drawings and the claims.

Drawings

The above and other objects, features and advantages of the present application will become more apparent by describing in more detail embodiments of the present application with reference to the attached drawings. The accompanying drawings are included to provide a further understanding of the embodiments of the application and are incorporated in and constitute a part of this specification, illustrate embodiments of the application and together with the description serve to explain the principles of the application. In the drawings, like reference numbers generally indicate like parts or steps.

Figure 1 illustrates a schematic view of a proximal-distal double tap ureteroscope, according to an embodiment of the present application.

Figure 2 illustrates a schematic view of a scope body of a proximal-distal double click ureteroscope, according to an embodiment of the present application.

Figure 3A illustrates one of the partial schematic views of the tube lens body of the proximal-distal double click ureteroscope according to embodiments of the present application.

Figure 3B illustrates a second schematic view of a portion of the body of a ureteroscope for a proximal-distal double click ureteroscope, according to an embodiment of the present application.

Figure 3C illustrates a third schematic partial view of a scope body of a proximal-distal double click ureteroscope, according to an embodiment of the present application.

Figure 3D illustrates four of a partially schematic view of a tube lens body of a distal-proximal double click ureteroscope, according to embodiments of the present application.

Figure 3E illustrates five of a partial schematic view of a tube lens body of a proximal-distal double tap ureteroscope, according to an embodiment of the present application.

Figure 4A illustrates a partial perspective view of a proximal-distal double tap ureteroscope, according to an embodiment of the present application.

Figure 4B illustrates one of the schematic partial cross-sectional views of a proximal-distal double click ureteroscope, according to an embodiment of the present application.

Figure 4C illustrates a second partial perspective cross-sectional view of a distal-proximal double click ureteroscope, according to embodiments of the present application.

Fig. 5A illustrates a partial perspective view of a proximal-distal double click ureteroscope according to one variation of an embodiment of the present application.

Fig. 5B illustrates one of the schematic partial cross-sectional views of a proximal-distal double tap ureteroscope according to one variation of the embodiments of the present application.

Fig. 5C illustrates a second schematic partial cross-sectional view of a proximal-distal double tap ureteroscope according to a variation of the embodiments of the present application.

Figure 6A illustrates a partial perspective view of a distal-proximal double click ureteroscope, according to another variant embodiment of the present application.

Fig. 6B illustrates one of the schematic partial cross-sectional views of a proximal-distal double click ureteroscope according to another variant embodiment of the present application.

Fig. 6C illustrates a second schematic partial cross-sectional view of a proximal-distal double tap ureteroscope according to another variation of the embodiments of the present application.

Fig. 7A illustrates a partial perspective view of a proximal-distal double click ureteroscope according to yet another variant embodiment of the present application.

Fig. 7B illustrates one of the schematic partial cross-sectional views of a proximal-distal double click ureteroscope according to yet another variant embodiment of the present application.

Fig. 7C illustrates a second schematic partial cross-sectional view of a proximal-distal double tap ureteroscope according to yet another variation of the embodiments of the present application.

Fig. 8A illustrates a partial perspective view of a proximal-distal double click ureteroscope according to yet another variant embodiment of the present application.

Fig. 8B illustrates one of the schematic partial cross-sectional views of a proximal-distal double click ureteroscope according to yet another variant embodiment of the present application.

Fig. 8C illustrates a second schematic partial cross-sectional view of a proximal-distal double tap ureteroscope according to yet another variation of the embodiments of the present application.

Figure 9A illustrates a partial perspective view schematic of a distal-proximal double click ureteroscope, according to yet another variant embodiment of the present application.

Fig. 9B illustrates one of the schematic partial cross-sectional views of a proximal-distal double click ureteroscope according to yet another variant embodiment of the present application.

Fig. 9C illustrates a second schematic partial cross-sectional view of a proximal-distal double tap ureteroscope according to yet another variation of the embodiments of the present application.

Figure 10A illustrates one of the working process schematics of a proximal-distal double tap ureteroscope according to embodiments of the present application.

Fig. 10B illustrates a second schematic operation process of the proximal-distal double-strike ureteroscope according to the embodiment of the present application.

Fig. 10C illustrates a third schematic operation process of the proximal-distal double-click ureteroscope according to the embodiment of the present application.

Figure 11 illustrates a flow diagram of a method of removing a stone with a ureteroscope, according to an embodiment of the present application.

Detailed Description

Hereinafter, example embodiments according to the present application will be described in detail with reference to the accompanying drawings. It should be understood that the described embodiments are only some embodiments of the present application and not all embodiments of the present application, and that the present application is not limited by the example embodiments described herein.

Summary of the application

As described above, in practical use, when the size of a stone is large in the process of hitting the stone through a ureteroscope, it is difficult to pulverize the stone into powder after the stone is crushed to an equivalent diameter of about 2mm by a conventional ureteroscope.

To address this problem, ureteroscopy designs are proposed that are capable of removing the debris. In this design, the ureteroscope is provided with a discharge mechanism to discharge the crushed stones out of the body in time. However, in practical use, the crushed stones are easily clogged in the discharge mechanism of the ureteroscope, and the removal efficiency of the stones is low, resulting in a long operation time.

Specifically, there are currently two main solutions to avoid clogging of crushed stones, the first: the crushed stones are hit again before entering the discharging mechanism to be crushed stones with larger sizes, so that the crushed stones are hit into stones with smaller sizes and can be discharged through the discharging mechanism; and the second method comprises the following steps: and (4) dredging or cleaning the broken and blocked calculus.

In the first embodiment, it was found that when the calculi are embedded in the tissue and organ, the calculi are pressed against the tissue and organ after the calculi are impacted, are difficult to move backwards, and therefore bear most of the energy of the laser, and are easy to break. However, the stones which are just crushed are in a movable state, when laser is applied to the movable stones, the movable stones are not fixed and are bounced off after being impacted, so that the movable stones are difficult to be further crushed, and the stone removing efficiency is low.

In the second embodiment, it has been found that the process of switching back and forth between hitting the stone and clearing the clogged stone takes a long time. Specifically, in the process of removing calculus by using a ureteroscope, firstly, calculus embedded in a tissue organ is broken by laser, then, when the size of the broken calculus is large, or a large amount of broken calculus simultaneously flows to a discharge port of a discharge mechanism, the discharge port is blocked, the blocked calculus needs to be dredged or cleaned, then, the calculus embedded in the tissue organ is continuously hit, and when the blockage condition is serious, the calculus blocked in the discharge mechanism is dredged or cleaned, and the process is repeated, so that the calculus removing efficiency is also low, and the operation time is long.

The inventor of the application finds that in the traditional calculus removing process, the desynchronization of the beating calculus and the cleaning of the blocked calculus is one of the reasons for the low calculus removing efficiency. Accordingly, the inventor of the present application realizes the synchronization of hitting the calculus and cleaning the calculus by a relatively simple method to improve the calculus removal efficiency, thereby shortening the operation time. In addition, in the process of cleaning the calculus, the calculus blocked in the suction channel is cleaned while the calculus embedded in the kidney or the movable calculus is hit, so that the calculus removing efficiency is improved.

Based on this, the present application proposes a distal-proximal double-strike ureteroscope, which includes: an operation section; a tube lens body having a front end and a rear end, comprising: a tube structure body, at least one perfusion channel extending within the tube structure body from the rear end to the front end, a suction channel extending within the tube structure body from the front end to the rear end, the suction channel having a suction port at the front end; a first stone striking mechanism comprising: the first head part is protruded out of the front end part of the tube lens main body and is used for hitting stones; and, a second stone striking mechanism comprising: the second head part of the second stone striking mechanism is positioned at the suction port of the suction channel and is used for striking stones blocked at the suction port.

Exemplary ureteroscope

As shown in fig. 1-10C, a proximal-distal double tap ureteroscope 100 according to embodiments of the present application is illustrated. For convenience of explanation, the proximal-distal double-strike ureteroscope 100 will be described by taking as an example the application of the proximal-distal double-strike ureteroscope 100 to the treatment of a stone c in a renal pelvis p.

The proximal-distal double tap ureteroscope 100 may be used to examine the condition of the kidney, break up stones c within the renal pelvis p, and direct the discharge of broken stones. In an embodiment of the present application, the proximal-distal double-strike ureteroscope 100 includes: a tube lens body 10 having a front end portion 110 and a rear end portion 120, an operating portion 20 operatively connected to the rear end portion 120 of the tube lens body 10, and a first stone striking mechanism 14 and a second stone striking mechanism 15, as shown in fig. 1.

In practical applications, the tube lens body 10 as an insertion portion of the proximal-distal double-click ureteroscope 100 may extend from the urethra into the ureter or the kidney, and an image capturing device 300 and a light source 400 may be disposed on the tube lens body 10 to capture images of the kidney and a stone located in the kidney. Preferably, the tube scope body 10 has a smooth outer surface, or the outer surface of the tube scope body 10 is smooth after entering the patient, so that the tube scope body 10 can smoothly enter the kidney. The operation unit 20, as a bridge of the ureteroscope 100 connected to an external device, can be communicably connected to an image output device 500 (e.g., a computer communicably connected to the image capturing device 300) to acquire images of the kidney and the stone located in the kidney, thereby facilitating a user to observe the condition of the stone c in the pelvis p. Further, the operable member (e.g., the guide mechanism 600, the liquid injection device 700, the suction device 800) can perform other functional operations by the operation portion 20. For example, the crushed stones in the kidney are sucked by a suction device 800 communicating with the scope body 10 through the operation unit 20. The first stone striking mechanism 14 can be used for striking stones c embedded in the kidney or movable stones in the kidney, and the second stone striking mechanism 15 can be used for striking stones blocked in the suction port.

Specifically, the tube mirror body 10 includes a tube structure body 11, at least one perfusion channel 12, and a suction channel 13, as shown in fig. 2. The at least one priming channel 12 extends within the tubular structure body 11 from the rear end 120 to the front end 110, and the suction channel 13 extends within the tubular structure body 11 from the front end 110 to the rear end 120. Also, the perfusion channel 12 and the suction channel 13 are preferably independent of each other, so that directing fluid through the perfusion channel 12 into the kidney to impact the crushed stone, drawing fluid that entrains the crushed stone into the suction channel 13 can be done simultaneously, and avoiding interference between impacting and attracting stones.

As shown in fig. 2 to 3E, the at least one perfusion channel 12 has at least one perfusion port 121 at the front end portion 110 and at least one first operation port 122 in communication with the at least one perfusion port 121, and fluid can reach the kidney from the perfusion port 121 and impact crushed stones in the kidney. The suction channel 13 has a suction port 131 at the distal end portion 110 and a second operation port 132 communicating with the suction port 131, and when the fluid carrying the crushed stone reaches the vicinity of the suction port 131, the fluid is sucked to the suction port 131 and enters the suction channel 13 from the suction port 131 to form a water return loop. That is, the crushed stones may enter the suction channel 13 from the suction port 131 by the water backflow loop.

Accordingly, the operation portion 20 includes an operation body 21, a first operation end 22 provided to the operation body 21 and communicated with the perfusion channel 12, and a second operation end 23 provided to the operation body 21 and communicated with the suction channel 13. The operation portion 20 communicates with the perfusion channel 12 through the first operation end 22 communicating with the first operation port 122, and communicates with the suction channel 13 through the second operation end 23 communicating with the second operation port 132. The first operative end 22 is adapted to be connected to a priming device 700 and allow the priming device 700 to inject fluid through the perfusion channel 12 into the renal pelvis p to impact the crushed stones, and the second operative end 23 is adapted to be connected to a suction device 800 (e.g., an air pump) and allow the suction device 800 to suck fluid and crushed stones near the suction channel 13 through the suction channel 13. In order to control the negative pressure in the suction passage 13, in one embodiment of the present application, the operation part 20 further includes a negative pressure regulator 27, and the negative pressure regulator 27 is configured to regulate the air pressure in the suction passage 13.

It should be understood that the roles of the first operating end 22 and the second operating end 23 are not intended to limit the present application. The first operating end 22 and the second operating end 23 are also adapted to allow other devices to perform other functional operations. For example, the first manipulation end 22 is adapted to allow a guide mechanism 600 to pass through the perfusion channel 12 and guide the scope body 10 to a target location. It should also be understood that the operating portion 20 may include other operating ends to allow other devices to perform other functional operations.

It is worth mentioning that in practical applications, when the size of the crushed stones is large, or when a large number of crushed stones simultaneously rush toward the suction port 131, clogging is likely to occur. In the conventional stone removing scheme, the crushed stones can be prevented from blocking the suction port 131 due to large size by hitting the crushed stones again before entering the suction port 131, however, in the process, the crushed stones are in a movable state, are easy to escape when being subjected to impact force, and are difficult to be further crushed, and the stone removing efficiency is low in such a manner. The calculus which is broken up and blocked can be dredged or cleaned, however, the calculus needs to be switched back and forth between the stone striking and the blockage cleaning, the process is complicated, the removing efficiency of the calculus is low, and the time is long.

In particular, in the embodiments of the present application, synchronization of hitting a stone and cleaning the stone is achieved using a relatively simple method. In particular, depending on the state and location of distribution of stones, stones within the kidney may be classified as: a stone c embedded in the kidney, a movable stone and a blocking stone (for example, a stone blocking the suction port 131), wherein the stone c embedded in the kidney and the movable stone belong to a distal stone, the stone blocking the suction port 131 belongs to a proximal stone, and the movable stone and the blocking stone belong to a crushed stone. The double-light far-near double-hit ureteroscope 100 adopts a scheme of 'far-end-near-end double-hit' to achieve synchronization of hitting stones and clearing stones, namely, the far-end stones are hit while the near-end stones blocked at the suction port 131 are cleared, and then the stone removal efficiency is improved. The stones blocked by the suction ports 131 are further hit by the blocking action of the suction ports 131 against the crushed stones, so that the stones blocked by the suction ports 131 are rapidly crushed and discharged through the suction ports 131, thereby improving the stone discharge efficiency and the stone removal efficiency.

In the embodiment of the present application, a stone striking mechanism (distal end stone striking mechanism) for striking a distal stone and a stone striking mechanism (proximal end stone striking mechanism) for striking a stone clogged in the suction port 131 are provided, and stone removal efficiency is improved by the cooperation of the distal end stone striking mechanism and the proximal end stone striking mechanism. The distal and proximal stone striking mechanisms may be implemented as holmium lasers, or other laser mechanisms capable of emitting laser light, or other mechanisms capable of striking stones, and are not limited in this application.

Accordingly, in the present embodiment, the first stone striking mechanism 30 is designed as a distal stone striking mechanism, and the second stone striking mechanism 40 is designed as a proximal stone striking mechanism. The first stone striking mechanism 30 includes a first head 31 and a first body 32 extending rearward from the first head 31, the laser light generated by the first stone striking mechanism 30 is emitted from the first head 31, and the first head 31 protrudes from the front end 110 of the scope body 10 and strikes a stone c embedded in the kidney and a struck stone. The second stone striking mechanism 40 includes a second head portion 41 and a second body portion 42 extending rearward from the second head portion 41, the second head portion 41 emits laser light generated by the second stone striking mechanism 40, the second head portion 41 of the second stone striking mechanism 40 is located at the suction port 131 of the suction passage 13 to strike stones blocked at the suction port 131, and the first head portion 31 of the first stone striking mechanism 30 is located in front of the second head portion 41 of the second stone striking mechanism 40.

It is worth mentioning that the first stone striking mechanism 30 and the second stone striking mechanism 40 can cooperate with each other to improve the stone removing efficiency during the process of cleaning the stones blocked in the suction port 131. For example, the projection of the first head 31 of the first stone striking mechanism 30 corresponds to the suction port 131 in the axial direction of the scope body 10, so that after the first stone striking mechanism 30 strikes a stone, the struck stone corresponds to the suction port 131, and the stone is more easily introduced into the suction passage 13 from the suction port 131, thereby improving the stone extraction efficiency, improving the stone removal efficiency, and shortening the operation time.

For another example, when the crushed stones are blocked by the suction port 131, the second stone striking mechanism 40 may further crush the at least partially crushed stones or may disperse the at least partially crushed stones. The first stone striking mechanism 30 can be matched with the second stone striking mechanism 40 to strike stones on a laser emitting path impacted to the first stone striking mechanism 30 so as to quickly break the broken stones, so that the broken stones are smaller in size and easier to be discharged through the suction channel 13, and the stone removing efficiency is improved.

Preferably, the laser emitting path of the first stone striking mechanism 30 and the laser emitting path of the second stone striking mechanism 40 intersect with each other, so that the stone struck by the second stone striking mechanism 40 can reach the emitting path of the first stone striking mechanism 30 intersecting with the laser emitting path of the second stone striking mechanism 40 along the laser emitting path of the second stone striking mechanism 40, and then be broken. Specifically, the stones blocked by the suction port 131 can be impacted by the laser emitted by the second stone striking mechanism 40, so that the stones blocked by the suction port 131 move to the laser emission path of the first stone striking mechanism 30 along the S direction, and the laser emitted by the first stone striking mechanism 30 strikes the stones impacted on the laser emission path of the first stone striking mechanism 30 in the T direction forming an angle with the S direction, so that the stones moving along the S direction are instantaneously subjected to the force in the T direction forming an angle with the S direction, and thus, the stones can be relatively quickly broken into stones with smaller sizes, and are more easily discharged through the suction channel 13, and the stone removal efficiency is improved.

In one embodiment of the present application, the first head 31 and the second head 41 are not parallel in orientation, the laser beam generated by the first stone striking mechanism 30 is emitted in the direction in which the first head 31 is oriented, and the laser beam generated by the second stone striking mechanism 40 is emitted in the direction in which the second head 41 is oriented, so that the laser beam emitted from the second head 41 is not parallel to the laser beam emitted from the second head 41, so that the laser beam emitting path of the first stone striking mechanism 30 intersects with the laser beam emitting path of the second stone striking mechanism 40.

Accordingly, in this particular embodiment, the first head 31 is oriented in a first orientation and the second head 41 is oriented in a second orientation, the first and second orientations being at a predetermined angle, the predetermined angle being greater than 0 ° and less than 180 °.

It should be understood that the intersection of the laser emitting path of the first stone striking mechanism 30 and the laser emitting path of the second stone striking mechanism 40 can be realized by other embodiments. For example, the laser emitting direction of the first stone striking mechanism 30 and/or the laser emitting direction of the second stone striking mechanism 40 are designed to be adjustable, which is not a limitation of the present application.

It should be noted that when the orientation of the first head 31 and the orientation of the second head 41 are not parallel, the first head 31 of the first stone striking mechanism 30 needs to avoid the laser emitted by the second stone striking mechanism 40, so as to avoid the laser emitted by the second laser from damaging the first head 31. Accordingly, the first head 31 is not on the laser emission path of the second stone striking mechanism 40, that is, the first head 31 is offset from the laser emission path of the second stone striking mechanism 40.

Preferably, the first head 31 of the first stone striking mechanism 30 is movably disposed at the front end portion 110, so that the first stone striking mechanism 30 is more flexibly matched with the second stone striking mechanism 40. In a specific example of the present application, the first head 31 is telescopically provided to the scope body 10 to switch between a first state and a second state, when in the first state, the first head 31 extends from the front end portion 110 to a first position, when in the second state, the first head 31 extends from the front end portion 110 to a second position, and a distance between the first position and the front end portion 110 is greater than a distance between the second position and the front end portion 110. Thus, the first stone striking mechanism 30 may strike stones located farther from the tip portion 110 when in the first state, and may strike stones located closer to the tip portion 110 when in the second state.

Specifically, in the embodiment of the present application, the tube endoscope main body 10 further includes a first optical fiber channel 14 disposed on the tube structure main body 11, the first stone striking mechanism 30 is telescopically disposed on the first optical fiber channel 14, the first optical fiber channel 14 has a first stone breaking port 141 formed on the front end portion 110 and a third operation port 142 formed on the rear end portion 120, and the first head 31 is disposed on the first optical fiber channel 14 and extends from the first stone breaking port 141.

Correspondingly, the operating portion 20 further includes a third operating end 24 communicating with the first fiber channel 14, and the third operating end 24 communicates with the third operating port 142 to communicate with the first fiber channel 14. The third actuating end 24 allows the first stone striking mechanism 30 to pass through and enter the first fiber channel 14 from the third actuating port 142 communicating therewith. That is, the first stone striking mechanism 30 can enter the first optical fiber channel 14 through the third operation port 142 through the third operation end 24 of the operation portion 20, and then enter the kidney to strike stones.

Further, the tube lens main body 10 has a front end surface 1101 and an outer peripheral surface 1102, in the present embodiment, the first lithotriptic notch 141 is formed in the front end surface 1101 of the tube lens main body 10, and the front end surface 1101 is designed to: extends obliquely forward from a first side of the outer peripheral surface 1102 to a second side opposite to the first side in an axial direction set by the tube lens body 10. For example, the front end surface 1101 of the tube structure body 11 extends obliquely forward from a lower side set by the outer peripheral surface 1102 to an upper side opposite to the lower side in the axial direction set by the tube mirror body 10, as shown in fig. 3A.

It should be noted that any point on the front end surface 1101 is not located on the laser emitting path of the first stone striking mechanism 30 and the second stone striking mechanism 40, so as to avoid that the front end surface 1101 extending obliquely between the first side and the second side of the outer peripheral surface 1102 shields the laser emitted by the first stone striking mechanism 30 and the laser emitted by the second stone striking mechanism 40, and influences the striking action of the first stone striking mechanism 30 and the second stone striking mechanism 40 on the stone, and at the same time, avoid that the laser emitted by the first stone striking mechanism 30 and the laser emitted by the second stone striking mechanism 40 damage the front end surface 1101.

In the present embodiment, the first stone crushing port 141 is located on the side of the suction port 131, and the first head 31 extends from the side of the suction port 131, but the first head 31 may extend from the suction port 131 in a modified embodiment of the present embodiment, and this is not a limitation of the present invention.

Accordingly, in a variation of the embodiment of the present application, the first head 31 is movably disposed in the suction channel 13 to switch between a first extended state, a second extended state and a first retracted state, and when in the first extended state, the first head 31 extends out of the suction port 131 to a third position to hit stones that are further away from the front end 110; when in the second extended state, the first head 31 is extended to a fourth position to strike a stone closer to the leading end 110; when in the first retracted state, the first head 31 is retracted to the suction port 131 to hit stones blocked by the suction port 131, wherein the distance between the third position and the front end portion 110 is greater than the distance between the fourth position and the front end portion 110.

In a modified embodiment of the present application, the first stone striking mechanism 30 may be disposed in the suction channel 13, for example, the suction channel 13 is regarded as the first optical fiber channel 14, or the first optical fiber channel 14 is disposed in the suction channel 13, and this is not a limitation of the present application.

In other specific examples of the present application, the first stone striking mechanism 30 may also be fixed to the tube lens body 10, and this is not a limitation of the present application.

Preferably, the second head 41 of the second stone striking mechanism 40 is movably disposed in the suction channel 13 to switch between a third state and a fourth state, when in the third state, the second head 41 extends out of the suction port 131 for striking stones, and when in the fourth state, the second head 41 retracts into the suction port 131 for striking stones blocked in the suction port 131.

In practical applications, when the suction port 131 is not blocked, the second stone striking mechanism 40 and the first stone striking mechanism 30 may strike the stone c embedded in the kidney or the movable stone that does not reach the suction port 131 together; when the suction port 131 is blocked, the first stone striking mechanism 30 continues to strike the stone c embedded in the kidney or the movable stone, and the second stone striking mechanism 40 is switched to the second state, i.e., retracted to the suction port 131 to strike the stone blocked in the suction port 131.

Second hit stone mechanism 40 with first hit stone mechanism 30 hits the in-process of hitting stone c of inlaying in the kidney jointly, first hit stone mechanism 30 with the second hits the same position that stone mechanism 40 can hit the calculus simultaneously, also can hit the adjacent position of stone simultaneously, and like this, the calculus is beaten the bits of broken glass more easily, can improve rubble efficiency, and then improves calculus and gets rid of efficiency.

During the process that the second stone striking mechanism 40 and the first stone striking mechanism 30 strike the movable stone together, the first stone striking mechanism 30 and the second stone striking mechanism 40 can cooperate with each other, for example: the first stone striking mechanism 30 can emit laser to strike the movable stone, when the stone impacted by the laser moves to the emitting path of the second stone striking mechanism 40 along the third direction, the stone is struck by the second stone striking mechanism 40 in the fourth direction forming an included angle with the third direction, and the stone is easily and quickly broken, so that the stone removing efficiency can be improved. Of course, the second stone striking mechanism 40 can also strike the movable stone to the laser emitting path of the first stone striking mechanism 30 to quickly break up the movable stone.

It should be noted that when the size of the crushed stone is large or a large amount of crushed stones are simultaneously guided to the suction port 131, the crushed stones will be blocked by the suction port 131, which causes the suction port 131 to be blocked, which is not favorable for the crushed stones to be guided out, resulting in low stone removal efficiency. In the embodiment of the present application, the retention effect of the suction port 131 on the crushed stones provides convenience for positioning and striking the stones.

As described above, the stones which are just crushed are in a movable state, and when the laser is applied to the crushed stones, the movable stones are not fixed, and the movable stones are flicked after receiving the impact force, so that the movable stones are difficult to be further crushed. When the crushed stones are locked to the suction port 131, the positions of the crushed stones are relatively stable, and the second stone striking mechanism 40 located at the suction port 131 can strike stones blocked in the suction port 131. When the second stone striking mechanism 40 strikes the stones blocked by the suction port 131, the stones blocked by the suction port 131 abut against the inner peripheral wall of the suction passage 13, and when the impact force generated by the second stone striking mechanism 40 acts on the crushed stones, most of the energy generated by the second stone striking mechanism 40 is received by the crushed stones, so that the crushed stones can be more rapidly crushed. Through such a mode, not only can improve rubble efficiency, moreover, can hit the lithangiuria of being smashed and hit into lithangiuria that the size is lithangiuria, make it can be derived through attracting passageway 13 fast to improve the lithangiuria and derive efficiency, and then improve rubble and get rid of efficiency.

In a specific example of the present application, the tube lens main body 10 further includes a second optical fiber channel 15 communicated with the suction channel 13, the second stone striking mechanism 40 is telescopically disposed in the second optical fiber channel 15, and the second head 41 of the second stone striking mechanism 40 extends into the suction channel 13 through the second optical fiber channel 15 to extend out of the suction port 131 or reach the suction port 131. That is, the second head 41 of the second stone striking mechanism 40 can enter the suction passage 13 along the second optical fiber passage 15 and protrude out of the suction port 131 or reach the suction port 131.

In the embodiment of the present application, the second optical fiber passage 15 extends between the suction passage 13 and the rear end portion 120 of the tube mirror body 10, and the second optical fiber passage 15 has a communication port 151 communicating with the suction passage 13 and a fourth operation port 152 communicating with the communication port 151 and located at the rear end portion 120.

Accordingly, the operating portion 20 includes an operating end communicated with the second fiber channel 15, and in a specific example of the application, the third operating end 24 of the operating portion 20 is communicated with the fourth operating port 152 to be communicated with the second fiber channel 15. The third operating end 24 allows the second stone striking mechanism 40 to pass through and enter the second optical fiber passage 15 and the suction passage 13 communicating with the second optical fiber passage 15 from the fourth operating port 152 communicating therewith. That is, the second stone striking mechanism 40 can enter the second optical fiber channel 15 and the suction channel 13 communicating with the second optical fiber channel 15 through the third operation end 24 of the operation portion 20 from the fourth operation port 152, and then enter the kidney to strike the stones. In other embodiments of the present application, the operating portion 20 further includes other operating ends communicated with the second optical fiber channel 15, which is not limited in the present application.

In the embodiment of the present application, the second optical fiber channel 15 includes a main body section 154 and a communication section 155 extending between the main body section 154 and the suction channel 13, the communication section 155 is communicated with the suction channel 13 and the main body section 154, and the second head 41 extends into the suction channel 13 through the communication section 155. Specifically, the communication section 155 has the communication port 151 communicating with the suction passage 13, and communicates with the suction passage 13 via the communication port 151, and the communication section 155 extends obliquely upward from the main body section 154 to the suction passage 13 in a predetermined direction.

In a particular example of the application, the angle between said predetermined direction of extension and the central axis of said suction channel 13 is in the range of 0 ° to 45 °. Correspondingly, the included angle between the central axis of the communicating section 155 and the central axis of the suction channel 13 is in the range of 0 ° to 45 °, and the second head 41 of the second stone striking mechanism 40 can extend into the suction port 131 along the communicating section 155 at an angle of 0 ° to 45 ° with the central axis of the suction channel 13. It should be understood that the steeper the communication section 155 is, the closer the center axis thereof coincides with the center axis of the suction passage 13, and the faster the second stone striking mechanism 40 passes through the suction passage 13 and protrudes out of the suction port 131. The angle between the central axis of the communicating section 155 and the central axis of the suction channel 13 may be other angles, for example, 30 ° and 60 °, and is not limited in this application.

Further, in this specific example, the suction port 131 is formed in the front end surface 1101, and when the second stone striking mechanism 40 is in the second state, the front end of the second head 41 of the second stone striking mechanism 40 is flush with a surface formed by the outer edge of the suction port 131. The outer edge of the suction port 131 refers to the inner peripheral edge of the inner peripheral wall of the suction passage 13. When the suction port 131 is formed in the front end face 1101, the front end of the second head 41 is flush with the front end face 1101.

Further, in this specific example, the front end face 1101 is designed to: the suction port 131 formed in the front end surface 1101 extends obliquely forward in the axial direction set by the tube mirror body 10 from a first side of the outer peripheral surface 1102 corresponding to the first side of the suction passage 13 to a second side of the outer peripheral surface 1102 corresponding to the second side of the suction passage 13, opposite to the first side, and extends obliquely forward in the axial direction set by the tube mirror body 10 from the first side of the suction passage 13 to the second side of the outer peripheral surface 1102. Accordingly, the shape of the suction port 131 approximates an ellipse.

Specifically, the front end surface 1101 may be designed as a convex slope, a concave slope, a wave slope, and other types of slopes formed between the first side and the second side of the outer peripheral surface 1102, which is not limited in this application. In a specific example of the present application, the front end surface 1101 is designed as a wave-shaped slope surface depressed in the middle between the first side and the second side of the outer peripheral surface 1102.

It should be understood that, in other embodiments, the front end face 1101 of the tubular main body 11 may also be designed such that the front end face 1101 of the tubular main body 11 extends flush along the axial direction set by the mirror main body 10 from a first side of the outer peripheral surface 1102 to a second side opposite to the first side (i.e., an end of the front end face 1101 close to the first side of the suction channel 13 is flush with an end thereof close to the second side of the suction channel 13 in the axial direction), and this is not a limitation of the present application.

It is worth mentioning that when the front end surface 1101 is designed to extend forward along the axial direction set by the tube lens body 10 from a first side of the outer peripheral surface 1102 to a second side opposite to the first side, a relatively large distribution space is provided for the suction ports 131, and accordingly, the size of the suction ports 131 is relatively increased, so that a relatively large number of crushed stones can be allowed to pass through the suction passage 13 relatively quickly, the crushed stones are prevented from blocking the suction ports 131, the stone leading-out efficiency is improved, and the stone removing efficiency is further improved.

In this specific example, the length of the second head 41 of the second stone striking mechanism 40 extending out of the suction port 131 is 10 mm or less. In one embodiment, the length of the second head 41 extending out of the suction port 131 is 5 mm or less. In another embodiment, the length of the second head 41 extending out of the suction port 131 is more than 5 mm and less than 10 mm. In other specific examples of the present application, the length of the second head 41 of the second stone striking mechanism 40 extending out of the suction port 131 may be greater than 10 mm, and this is not a limitation of the present application.

In this specific example, when the second stone striking mechanism 40 is in the second state, the second head 41 of the second stone striking mechanism 40 is located in the middle region of the suction port 131. Specifically, in the process of switching the second stone striking mechanism 40 from the first state to the second state, the second stone striking mechanism 40 can retract along the communicating section 155 in the direction opposite to the preset direction, and when the second stone striking mechanism 40 retracts to the suction port 131, the second head 41 of the second stone striking mechanism 40 is located in the middle region of the suction port 131.

It is noted that the position where the stone blocked in the suction port 131 abuts against the inner peripheral wall of the suction passage 13 is uncertain, and when the stone blocked in the suction port 131 is hit from the peripheral edge region of the suction port 131 formed around the central region, the stone may remain locked in the suction port 131, and the stone breaking efficiency is low. For example, when the second hitting mechanism 40 hits the first part of the stone blocking the suction port 131 from the first peripheral region or hits the second part of the stone blocking the suction port 131 from the second peripheral region, the stone blocking the suction port 131 may be detached from the suction port 131 and enter the suction passage 13 along with the chipping of the first part or the second part. However, when the second stone striking mechanism 40 strikes the portion of the stone blocked by the suction port 131, which is suspended from the suction port 131, the first portion or the second portion of the stone blocked by the suction port 131 may still abut against the inner peripheral wall and be caught by the suction port 131. When the second stone striking mechanism 40 strikes the stones blocked by the suction port 131 from the middle region of the suction port 131, the middle portions of the stones blocked by the suction port 131 corresponding to the middle region of the suction port 131 are struck, and the stones blocked by the suction port 131 are broken away from the middle portions and detached from the suction port 131. Therefore, it is preferable that the second head 41 of the second stone striking mechanism 40 is located in a middle region of the suction port 131 when the second stone striking mechanism 40 is in the second state. It should be understood that, when the second stone striking mechanism 40 is in the second state, the second head 41 of the second stone striking mechanism 40 may also be located at other positions of the suction port 131, which is not limited in this application.

In a modified embodiment of the present application, the second stone striking mechanism 40 may also be disposed in the suction channel 13, for example, the suction channel 13 may be regarded as the second optical fiber channel 15, or the second optical fiber channel 15 is disposed in the suction channel 13, and the second optical fiber channel 15 has the second operation port 153 located at the suction port 131, which is not limited by the present application.

In other specific examples of the present application, the second head 41 may be fixedly disposed at the suction port 131, and the present application is not limited thereto.

In the embodiment of the present application, the proximal-distal double-strike ureteroscope 100 further includes a third stone striking mechanism 50 disposed on the ureteroscope body 10, and the third stone striking mechanism 50 includes a third body portion 52 and a third head portion 51 extending forward from the third body portion 52. Preferably, the laser emitting path of the third stone striking mechanism 50 intersects with the laser emitting path of the first stone striking mechanism 30 and/or the laser emitting path of the second stone striking mechanism 40, so as to rapidly strike stones through the mutual cooperation of the first stone striking mechanism 30, the second stone striking mechanism 40 and the third stone striking mechanism 50, thereby improving stone breaking efficiency and further improving stone removing efficiency.

It is worth mentioning that, in the embodiment of the present application, the projection of the third head 51 in the axial direction of the tube lens body 10 corresponds to the suction port 131. Thus, after the third stone-hitting mechanism 50 hits and breaks the stones, the broken stones are more likely to enter the suction passage 13 from the suction port 131 in correspondence to the suction port 131, and the stone-leading-out efficiency and the stone-removing efficiency can be improved.

In the embodiment of the present application, the third head 51 of the third stone striking mechanism 50 is provided to the front end portion 110. Preferably, the third head 51 of the third stone striking mechanism 50 is movably provided to the front end portion 110. In a specific example of the present application, the third stone striking mechanism 50 is telescopically disposed in the tube lens body 10 to switch between a fifth state and a sixth state, when the fifth state is set, the third head 51 extends from the front end portion 110 to a fifth position, when the sixth state is set, the third head 51 extends from the front end portion 110 to a sixth position, and a distance between the fifth position and the front end portion 110 is greater than a distance between the sixth position and the front end portion 110. Thus, when the third stone striking mechanism 50 is in the fifth state, it can strike stones that are farther from the front end portion 110, and when the third stone striking mechanism 50 is in the sixth state, it can strike stones that are closer to the front end portion 110.

In the embodiment of the present application, the tube endoscope main body 10 further includes a third optical fiber channel 16 disposed on the tube structure main body 11, the third optical fiber channel 16 has a third lithotripsy port 161 formed on the front end face 1101 and a fifth operation port 162 formed on the rear end portion 120, and the third head portion 51 is disposed on the third optical fiber channel 16 and protrudes from the third lithotripsy port 161.

Accordingly, the operating portion 20 includes an operating end communicating with the third fiber channel 16, and in a specific example of the present application, the third operating end 24 of the operating portion 20 communicates with the fifth operating port 162 to communicate with the third fiber channel 16. The third actuating end 24 allows the third mechanism 50 to pass through and enter the third fiber channel 16 from the fifth actuating port 162 communicating therewith. That is, the third stone striking mechanism 50 can enter the third optical fiber channel 16 through the third operation end 24 of the operation portion 20 from the fifth operation port 162, and then enter the kidney to strike stones. In other embodiments of the present application, the operation portion 20 further includes another operation end communicated with the third optical fiber channel 16, which is not limited in the present application.

In a specific example of the present application, the length of the third head portion 51 of the third stone striking mechanism 50 extending out of the third stone crushing opening 161 is less than or equal to 10 mm, and in other specific examples of the present application, the length of the third head portion 51 of the third stone striking mechanism 50 extending out of the third stone crushing opening 161 is greater than 10 mm, which is not limited by the present application.

In the embodiment of the present application, the third lithotripsy port 161 is formed at a side of the suction port 131, and the third head 51 protrudes from a side of the suction port 131, but in a modified embodiment of the present application, the third head 51 may protrude from the suction port 131, and this is not a limitation of the present application.

Accordingly, in a modified embodiment of the present embodiment, the third optical fiber channel 16 is communicated with the suction channel 13, the third head 51 of the third stone striking mechanism 50 is movably disposed in the suction channel 13 to switch between a third extended state, a fourth extended state and a second retracted state, and when in the third extended state, the third head 51 extends from the front end 110 to a seventh position; when in the fourth extended state, the third head 51 is extended from the front end portion 110 to the eighth position; when in the second retracted state, the third head 51 is retracted to the suction port 131, wherein a distance between the seventh position and the leading end portion 110 is greater than a distance between the eighth position and the leading end portion 110.

In a modified embodiment of the present application, the third stone striking mechanism 50 may be disposed in the suction channel 13, for example, the suction channel 13 may be regarded as the third optical fiber channel 16, or the third optical fiber channel 16 may be disposed in the suction channel 13, which is not limited to the present application.

In a modified embodiment of the example of the present application, the third stone striking mechanism 50 may be fixed to the tube lens body 10, but is not limited to the present application.

In the embodiment of the present application, the first optical fiber channel 14, the second optical fiber channel 15, and the third optical fiber channel 16 are all located at the side of the suction channel 13, and the orientation of the first optical fiber channel 14, the second optical fiber channel 15, and the third optical fiber channel 16 is not limited by the present application. For example, the first fiber channel 14 and the second fiber channel 15 may be designed such that: the first optical fiber passage 14 is formed at the third side of the suction passage 13, and the second optical fiber passage 15 is formed at the first side of the suction passage 13, as shown in fig. 4A to 4C; it can also be designed as follows: the first optical fiber passage 14 is formed on the third side of the suction passage 13, and the second optical fiber passage 15 is formed on the second side of the suction passage 13, as shown in fig. 5A to 5C; can also be designed as follows: the first optical fiber channel 14 is formed on the fourth side of the suction channel 13, and the second optical fiber channel 15 is formed on the second side of the suction channel 13, as shown in fig. 6A to 6C; or, the design is that: the first optical fiber passage 14 is formed on the fourth side of the suction passage 13, and the second optical fiber passage 15 is formed on the first side of the suction passage 13, as shown in fig. 7A to 7C. The first side and the second side are opposite, the third side and the fourth side are opposite, and the third side and the fourth side are located between the first side and the second side.

The first, second and third fibre channels 14, 15, 16 may be designed such that: the first optical fiber channel 14 is formed on the fourth side of the suction channel 13, the second optical fiber channel 15 is formed on the first side of the suction channel 13, and the third optical fiber channel 16 is formed on the third side of the suction channel 13, as shown in fig. 8A to 8C; or is designed to: the first optical fiber passage 14 is formed on the fourth side of the suction passage 13, the second optical fiber passage 15 is formed on the second side of the suction passage 13, and the third optical fiber passage 16 is formed on the third side of the suction passage 13, as shown in fig. 9A to 9C.

When the front end surface 1101 extends obliquely forward in the axial direction set by the tube mirror body 10 from a first side of the outer peripheral surface 1102 to a second side opposite to the first side, and the suction port 131 formed in the front end surface 1101 extends obliquely forward in the axial direction set by the tube mirror body 10 from the first side of the suction passage 13 to the second side opposite to the first side, the shape of the suction port 131 as a whole is similar to an ellipse. The suction port 131 has a long axis L1 and a short axis L2, and the suction port 131 has a first end 11011 and a second end 11012 on the long axis L1, and a third end 11013 and a fourth end 11014 on the short axis L2. The first end 11011 and the second end 11012 are opposite, and the first end 11011 of the suction port 131 is located rearward relative to the second end 11012, that is, the first end 11011 is located rearward of the second end 11012. The third end 11013 and the fourth end 11014 are opposite and are located between the first end 11011 and the second end 11012.

The first side refers to a side close to the first end point 11011, the second side refers to a side close to the second end point 11012, the third side refers to a side close to the third end point 11013, and the fourth side refers to a side close to the fourth end point 11014. It should be understood that the first optical fiber passage 14, the second optical fiber passage 15 and the third optical fiber passage 16 may be formed at other sides of the suction passage 13, for example, a fifth side between the first side and the third side, and this is not a limitation of the present application.

It should be noted that the second optical fiber channel 15 is formed at the side of the suction channel 13, and the second stone striking mechanism 40 is telescopically disposed in the second optical fiber channel 15, when the second stone striking mechanism 40 is in the third state or the fourth state, only the front portion of the second stone striking mechanism 40 including the second head 41 is located in the suction channel 13, and the rear portion of the second stone striking mechanism 40 is located in the second optical fiber channel 15, so as not to occupy the space in the suction channel 13, and thus, the second stone striking mechanism 40 can be prevented from affecting the passage of the struck stones through the suction channel 13.

In the embodiment of the present application, the positions of the first stone striking mechanism 30 and the third stone striking mechanism 50 may be interchanged, and this is not a limitation of the present application.

In the embodiment of the present application, the perfusion channel 12, the suction channel 13, the first optical fiber channel 14, the second optical fiber channel 15, and the third optical fiber channel 16 are not limited to the formation manner of the present application. The perfusion channel 12, the suction channel 13, the first optical fiber channel 14, the second optical fiber channel 15, and the third optical fiber channel 16 may be formed by a plurality of holes formed in the tube structure body 11 itself, or may be formed by a plurality of hollow tubes cooperatively, which is not limited in this application.

During the beating of a stone, the irrigation channel 12 may direct fluid exiting from its irrigation port 121 to impact the crushed stone and entrain the crushed stone for movement. The air pressure in the suction channel 13 is in a negative pressure state, so that when the fluid entrains the crushed stone to move to a position close to the suction port 131, the fluid and the crushed stone are sucked to the suction channel 13. However, during the impact of the fluid on the crushed stone, it may be disturbed by the suction forces in the suction channel 13.

In particular, in some specific examples of the present application, the suction interference to the fluid is reduced by adjusting the relative position relationship between the perfusion opening 121 and the suction opening 131 and controlling the flow direction of the fluid, so as to improve the calculus removal efficiency. The perfusion port 121 of the perfusion channel 12 has a first orientation for allowing fluid to be injected into the renal pelvis p along the perfusion channel 12 from the perfusion port 121 in a first direction directed in the first orientation, and the suction port 131 of the suction channel 13 has a second orientation at a preset angle to the first orientation for allowing the fluid to be sucked into the suction channel 13 from the suction port 131 in a second direction directed in the second orientation after being deflected within the renal pelvis p to form a fluid loop.

The second orientation is different from the first orientation, the first direction is the same as the first orientation, and the second orientation is opposite to the second orientation, so that an included angle between the first direction and the second direction is not 0 ° or 180 °, that is, the first direction and the second direction are different from each other and are not opposite to each other. In this way, the fluid emitted from the pouring port 121 along the first direction is deflected and then flows back along the second direction having an included angle with the first direction, so as to form a vortex-type fluid loop, which can prevent the fluid from directly flowing back along the opposite direction of the first direction to the suction port 131 facing the same direction as the pouring port 121 after being emitted from the pouring port 121 along the first direction, and further reduce the interference of the negative pressure in the suction channel 13 on the fluid.

It should be noted that, in other specific examples of the present application, the first orientation and the second orientation may be the same, and the first direction and the second direction may also be the same or opposite to each other, which is not limited by the present application.

In the embodiment of the present application, an included angle between the first direction and the second direction is greater than or equal to 90 ° and less than 180 °. In a specific example, the second direction is parallel to or infinitely close to the axial direction set by the tube lens body 10, the angle between the first direction and the axial direction set by the tube lens body 10 is greater than 0 ° and less than or equal to 90 °, and correspondingly, the angle between the first direction and the second direction is greater than or equal to 90 ° and less than or equal to 180 °. In another specific example, the first direction is parallel to or infinitely close to the axial direction set by the tube lens body 10, the angle between the second direction and the axial direction set by the tube lens body 10 is greater than 0 ° and less than or equal to 90 °, and accordingly, the angle between the first direction and the second direction is greater than or equal to 90 ° and less than or equal to 180 °.

In a specific embodiment of the present application, an included angle between the central axis of the perfusion opening 121 and the central axis of the suction opening 131 is greater than 0 ° and less than or equal to 90 °, so that the first direction and the second direction form a preset included angle.

In the embodiment of the present application, the perfusion opening 121 and the suction opening 131 are not flush in the set axial direction of the tube lens main body 10, so that the distance between the perfusion opening 121 and the suction opening 131 and the movement path of the fluid can be extended, which not only can reduce the interference of the suction of the negative pressure in the suction channel 13 to the fluid, but also can improve the efficiency of leading out the crushed stone because the area range through which the fluid flows is wider and the crushed stone on the movement path of the fluid that the fluid can wrap is relatively more.

Here, the fact that the perfusion opening 121 and the suction opening 131 are not flush with each other in the set axial direction of the tube lens body 10 means that there is a difference in height between the perfusion opening 121 and the suction opening 131 in the set axial direction of the tube lens body 10, and the distances between the perfusion opening 121 and the suction opening 131 and the front end point located at the forefront of the tube lens body 10 are different. In a specific example, the distance between the infusion port 121 and the front end point of the tube mirror body 10 is greater than the distance between the suction port 131 and the front end point of the tube mirror body 10, that is, the suction port 131 is located in front of the infusion port 121 in the axial direction set by the tube mirror body 10, and the suction port 131 is closer to the front end point of the tube mirror body 10 than the infusion port 121. In another specific example, the distance between the perfusion port 121 and the front end point of the tube mirror body 10 is smaller than the distance between the suction port 131 and the front end point of the tube mirror body 10, that is, the perfusion port 121 is located in front of the suction port 131, and the perfusion port 121 is closer to the front end point of the tube mirror body 10 than the suction port 131.

In a modified embodiment of the present application, the perfusion port 121 and the suction port 131 may be flush with each other in the axial direction set by the tube lens body 10, which is not intended to limit the present application.

In the present embodiment, the perfusion port 121 and the suction port 131 are two isolated openings, so as to reduce the suction interference of the fluid caused by the negative pressure in the suction channel 13. In some embodiments of the present application, the infusion port 121 and the suction port 131 are located at two different sides, respectively.

In a specific example of the present application, the perfusion port 121 is formed in the outer peripheral surface 1102 of the tube structure body 11, and the suction port 131 is formed in the front end surface 1101 of the tube structure body 11, as shown in fig. 5A to 5C. In this way, the perfusion opening 121 is opened laterally, the suction opening 131 is opened forward, fluid is injected into the renal pelvis p in the first direction from the perfusion opening 121 formed in the outer circumferential surface 1102 of the tube structure body 11, and after being diverted, fluid is sucked into the suction channel 13 from the suction opening 131 in the second direction bypassing the outer circumferential surface 1102, so that a vortex-type fluid loop is formed, and suction interference on the fluid can be reduced.

In particular, in this specific example, the pouring port 121 formed in the outer peripheral surface 1102 of the pipe structural body 11 mainly occupies the axial dimension of the pipe structural body 11, and the suction port 131 formed in the front end surface 1101 of the pipe structural body 11 mainly occupies the radial dimension of the pipe structural body 11. In this way, without coordinating the space ratio occupied by the pouring port 121 and the suction port 131 in the radial direction of the tubular structure body 11 under the condition that the radial dimension of the tubular structure body 11 is limited, the size of each of the suction port 131 and the pouring port 121 can be relatively increased, and the flexibility in designing the shape and number of the suction port 131 and the pouring port 121 is relatively improved. Through the reasonable arrangement of the perfusion opening 121 and the suction opening 131, the sizes of the suction opening 131 and the perfusion opening 121 can be relatively increased, so that broken stones can pass through the suction opening 131 and the suction opening 121 more easily, the stone guiding efficiency is improved, the operation time is shortened, and the liquid outflow quantity of the perfusion opening 121 of the perfusion channel 12 is ensured.

When the liquid outlet amount of the perfusion opening 121 is large, on one hand, the range of the fluid emitted from the perfusion opening 121 is relatively prolonged, the impact force on the crushed calculus is relatively increased, the attraction interference is relatively weakened, and the calculus leading-out efficiency is relatively improved. On the other hand, the proximal-distal double-strike ureteroscope 100 can achieve a large liquid outlet amount under a relatively low liquid injection pressure, and reduces the risk of pressure rise in the kidney.

It is worth mentioning that in the embodiment of the present application, the front end face 1101 of the tubular structural body 11 is designed to: extending forwardly in the axial direction set by the scope body 10 from a first side of the outer peripheral surface 1102 opposite the first side, the front face 1101 having a first end adjacent the first side of the outer peripheral surface 1102 and a second end adjacent the second side of the outer peripheral surface 1102, the second end being higher than the first end, the first end of the front face 1101 being flush with the second end of the front face 1101 compared to the front face 1101 being designed to extend flush from the first side of the outer peripheral surface 1102 opposite the first side, the first end of the front face 1101 being flush with the second end of the front face 1101, the path of fluid detour being extended, not only being relatively less disturbed by attraction, but also being relatively more broken stones in the path of fluid movement that can be trapped due to the wider area through which the fluid flows, and the stone extraction efficiency being improved.

It is worth mentioning that the diameter of the perfusion channel 12 is preferably equal to or slightly larger than the diameter of the suction channel 13 to achieve a flow balance. Here, the diametrical size of the perfusion channel 12 equal to or slightly greater than the diametrical size of the suction channel 13 means: the sum of the equivalent diameters of all the perfusion channels 12 is equal to or slightly larger than the sum of the equivalent diameters of all the suction channels 13.

In one embodiment of the present application, the number of the suction ports 131 is 1, and the number of the pouring ports 121 is 2, as shown in fig. 3A to 3E. Correspondingly, the at least one perfusion channel 12 comprises a first perfusion channel having a first perfusion opening at the front end portion 110 and a second perfusion channel having a second perfusion opening at the front end portion 110, the first and second perfusion openings being oppositely arranged.

In another embodiment of the present application, the number of the suction ports 131 is 1, the number of the perfusion ports 121 is 2, the perfusion channel 12 is formed around the suction channel 13, that is, the perfusion channel 12 is formed around the suction channel 13, or the cross section of the perfusion channel 12 is annular, the perfusion channel 12 has two perfusion ports 121 formed at the front end portion 120, and the two perfusion ports 121 are located at the outer circumferential surface 1102.

It should be understood that the size, shape and number of the suction ports 131 and the perfusion ports 121 are not limited to the present application, and the size, shape and number of the suction ports 131 and the perfusion ports 121 can be adjusted according to the actual application to realize the controllable and ordered fluid loop.

It should be noted that the positions of the suction port 131 and the pouring port 121 are not limited to the present application, and in other specific examples, the suction port 131 and the pouring port 121 may be disposed at other positions. In another specific example of the present application, the suction port 131 and the infusion port 121 are provided on the outer peripheral surface 1102 and the front end surface, respectively.

In yet another specific example of the present application, the suction port 131 and the infusion port 121 are both provided to the front face 1101 of the tube structure body 11. Specifically, in this specific example, the perfusion channel 12 is formed circumferentially around the suction channel 13, that is, the perfusion channel 12 is an annular channel formed circumferentially around the suction channel 13, or the cross section of the perfusion channel 12 is annular, the perfusion channel 12 has two perfusion openings 121 formed in the front end portion 120, and the two perfusion openings 121 are located on both sides of the suction opening 131.

In the embodiment of the present application, the proximal-distal double click ureteroscope 100 further includes an image capture device 300 and a light source 400 mounted on the ureteroscope body 10 to capture images of the kidney and stones located in the kidney. The positions of the image capturing apparatus 300 and the light source 400 are not limited by the present application, and preferably, the suction port 131 of the suction channel 13 is located in the visible area of the image capturing apparatus 300 to capture the situation near the suction port 131, so that the user can observe the guiding-out situation of the crushed stone. The light source 400 may be disposed near the image pickup device 300 to provide a sufficient amount of light to the image pickup device 300.

Accordingly, the operation part 20 further includes a fourth operation terminal 25 communicably connected to the image pickup device 300. Also, the image output device 500 (e.g., a computer communicably connected to the image capturing device 300) may be communicably connected to the image capturing device 300 through the operating portion 20 to acquire images of the kidney and the stone located in the kidney, so that the user can observe the condition of the stone c in the renal pelvis p.

It is worth mentioning that, in order to ensure the stiffness of the tube lens main body 10 while ensuring that the tube lens main body 10 can be bent to reach different target positions, the tube lens main body 10 includes a flexible portion 1010 adjacent to the front end portion 110 and a rigid portion 1020 coupled to the flexible portion 1010. The rigid portion 1020 may extend rearward from the flexible portion 1010, or the rigid portion 1020 may cover at least a portion of the flexible portion 1010 to ensure local stiffness of the tube lens body 10.

Correspondingly, the operation part 20 further comprises a fifth operation end 26 operatively connected to the flexible part 1010 and an operation mechanism 28 mounted on the fifth operation end 26, wherein the operation mechanism 28 is operatively connected to the flexible part 1010 through the fifth operation end 26 to control the bending degree of the flexible part 1010, so that the main body 10 of the endoscope can reach different target positions, and the bending degree of the flexible part 1010 can be adjusted according to actual conditions. In one specific example, the operating mechanism 28 includes a control wire 281 connected to the flexible portion 1010 and an adjuster 282 connected to the control wire 281, wherein the adjuster 282 is configured to drive the control wire 281 to pull the flexible portion 1010 to bend the flexible portion 1010. The structure of the operating mechanism 28 and the manner of controlling the bending of the flexible portion 1010 are not limited in this application, i.e., the operating mechanism 28 can be designed in other structures and control the bending of the flexible portion 1010 in other manners.

In a specific example, at least a part of the front end portion 110 of the scope body 10 is the flexible portion 1010, so that the perfusion channel 12 and the suction channel 13 can be bent, and the suction port 131 and the perfusion port 121 can be directed toward the calculus c at the target position. The flexible portion 1010 includes an active bending portion 1011 and a passive bending portion 1012, the active bending portion 1011 is bendable by the manipulation of the operation portion 20 and maintains a bent state, and the passive bending portion 1012 is bent according to the bending of the active bending portion 1011.

Exemplary methods of removing calculus

As shown in fig. 11, a method of removing stones with a ureteroscope according to the present application is illustrated, which includes: s110, beating the calculus through the laser emitted by the first calculus beating mechanism; s120, guiding the crushed stones to reach a suction port of the suction channel through the fluid return ring; and S130, the stones blocked at the suction port are hit by the laser emitted by the second stone hitting mechanism, so that the stones blocked at the suction port can be broken and then discharged through the suction port.

The operation of the proximal-distal double-strike ureteroscope 100 will be described below by taking the application of the proximal-distal double-strike ureteroscope 100 to the removal of a stone c in a renal pelvis p as an example.

In step S110, the laser beam emitted from the first stone striking mechanism 30 strikes the stone. Preparation is required before the laser emitted by the first stone striking mechanism 30 strikes the stone. Specifically, first, the tube scope body 10 may be inserted to an initial predetermined position of the kidney. Specifically, the scope body 10 may be advanced along the patient's ureter into the kidney and to an initial predetermined location. In this process, an image of the surrounding environment where the ureteroscope body 10 passes can be acquired and displayed by the image acquisition device 300 provided to the ureteroscope body 10 and the image output device 500 communicably connected to the image acquisition device 300, and the proximal-distal double click ureteroscope 100 is guided to the initial predetermined position in cooperation with the guide mechanism 600. Specifically, the guide mechanism 600 can enter the perfusion channel 12 through the operation part 20 and guide the proximal-distal double-click ureteroscope 100 to the initial predetermined position, and after the ureteroscope body 10 reaches the initial predetermined position, the guide mechanism 600 can be taken out.

The first and second stone striking mechanisms 30 and 40 may be placed at the initial predetermined positions of the kidney before the insertion of the tube lens body 10 or after the insertion of the tube lens body 10. The first and second striking mechanisms 30 and 40 are respectively provided in the first and second optical fiber passages 14 and 15 and can be extended from and retracted from the distal end portion 110 of the tube lens body 10.

Next, the flexible portion 1010 is controlled to bend by the operating mechanism 28 of the operating portion 20 so that the leading end portion 110 of the scope body 10 is directed toward the stone c at the target position within the renal pelvis p. After the front end portion 110 of the scope body 10 is directed to the calculus c at the target position, the laser emitted from the first calculus striking mechanism 30 strikes the calculus, as shown in fig. 10A.

In controlling the bending of the flexible portion 1010 by the operating mechanism 28 of the operating portion 20, the flexible portion 1010 can be controlled to bend at a desired degree of bending according to a target position. When the proximal-distal double click ureteroscope 100 is used to click a stone c located in the suprarenal pelvis, the flexible portion 1010 is controlled to bend at a first degree of curvature, when the proximal-distal double click ureteroscope 100 is used to click a stone c located in the mesorenal pelvis, the flexible portion 1010 is controlled to bend at a second degree of curvature, and when the proximal-distal double click ureteroscope 100 is used to click a stone c located in the infrarenal pelvis, the flexible portion 1010 is controlled to bend at a third degree of curvature, the third degree of curvature being greater than the second degree of curvature and the first degree of curvature.

It should be noted that, in the process of hitting the stone with the laser emitted from the first stone hitting mechanism 30, when the first stone hitting mechanism 30 is movably disposed on the tube lens main body 10, the length of the first head 31 extending out of the front end portion 110 can be adjusted according to the stone c and the distance from the front end portion 110 of the tube lens main body 10, so as to approach and hit the stone c. The first head 31 is extended to a first position to strike a stone c when the stone c is farther from the front face 110 and retracted to a second position to strike a stone c when the stone c is closer to the front face 110.

When the stones c are crushed, the crushed stones can be hit by the first stone-hitting mechanism 30 and the second stone-hitting mechanism 40. And, the length of the first head 31 extending out of the front end 110 can be adjusted according to the distance between the crushed stone and the front end 110, so as to further crush the crushed stone.

The stone c can be hit continuously by the first stone hitting mechanism 30, and the broken stone can be hit by the third stone hitting mechanism 50 and the second stone hitting mechanism 40.

Accordingly, step S110 includes: extending the first head 31 of the first stone striking mechanism 30 to strike a stone; and retracting the first head 31 of the first stone striking mechanism 30 to strike a stone.

When the first head 31 of the first stone striking mechanism 30 is positioned in the suction channel 13 of the ureteroscope 100, the first head 31 can be retracted to the suction port 131 of the suction channel 13 to strike stones blocked in the suction port 131.

Accordingly, step S110 further includes: the first head 31 of the first stone striking mechanism 30 is retracted to strike the stone blocked at the suction port 131.

In step S120, the crushed stones are guided by the fluid loop to the suction opening 131 of the suction channel 13. Specifically, during the process of hitting the stone c by the first stone hitting mechanism 30, or after the stone c is hit by the first stone hitting mechanism 30, a fluid may be ejected from the infusion port 121 of the proximal-distal double-hit ureteroscope 100 to a target position to hit the hit stone. Specifically, a fluid may be injected into the perfusion channel 12 through the injection device 700 connected to the operating portion 20, and the fluid is injected to a target location to impact the crushed stones.

During the process of impacting the crushed stones, the crushed stones and the fluid can be attracted, so that the fluid is diverted to wrap the crushed stones and is sucked into the suction channel 13 from the suction port 131 to form a fluid loop, and the crushed stones are guided to the suction port 131 through the fluid loop and enter the suction channel 13 from the suction port 131. Specifically, the crushed stones and the fluid may be sucked by the suction apparatus 800 connected to the operation part 20, so that the fluid and the crushed stones are discharged through the suction passage 13 to maintain the pressure in the kidney. In the course of attracting the crushed stones into the suction channel 13 of the tube lens body 10, the suction force of the fluid and the crushed stones can be adjusted by adjusting the air pressure in the suction channel 13.

In the application embodiment, the perfusion port 121 is oriented in a first orientation, and the suction port 131 is oriented in a second orientation, and fluid can be injected into the renal pelvis p along the perfusion channel 12 from the perfusion port 121 in the first direction directed in the first orientation, and can be sucked into the suction channel 13 of the proximal-distal double-click ureteroscope 100 from the suction port 131 after being deflected in the second direction directed in the second orientation to form a fluid loop back so as to guide the crushed stones into the suction channel 13.

In the embodiment of the present application, the following are adopted: the scheme of 'far-near end double-beating' can realize that: the method is relatively simple, can improve the stone removing efficiency and further shorten the operation time when the stones c embedded in the kidney or the movable stones are hit and the stones blocked at the suction port 131 of the suction channel 13 are cleaned.

Accordingly, in step S130, the laser beam emitted from the second hitting mechanism 40 hits the stone blocking the suction port 131. It should be noted that when the crushed stone is clogged in the suction port 131, the crushed stone is locked to the suction port 131, and the distal-proximal double-strike ureteroscope 100 can further strike the stone clogged in the suction port 131 by the locking action of the suction port 131 to the crushed stone, as shown in fig. 10B. In this way, the stones blocked in the suction ports 131 can be quickly crushed and then discharged through the suction ports 131, so as to improve the stone leading-out efficiency and further improve the stone removing efficiency.

It is also worth mentioning that the first stone striking mechanism 30 may cooperate with the second stone striking mechanism 40 during the process that the laser emitted from the second stone striking mechanism 40 strikes the stone blocked at the suction port 131. Specifically, when the crushed stone is blocked by the suction port 131, the second stone striking mechanism 40 may firstly blow off the stone blocked by the suction port 131, and when the blown-off stone moves to the laser emission path of the first stone striking mechanism 40, the blown-off stone may be struck again by the first stone striking mechanism 30, as shown in fig. 10C. Therefore, the broken stones are more easily broken, the stone breaking efficiency can be improved, and the stone removing efficiency is further improved.

When the second stone striking mechanism 40 is movably disposed on the tube lens main body 10, the second stone striking mechanism 40 and the first stone striking mechanism 30 can cooperate with each other to quickly strike stones embedded in the kidney or movable stones.

In the process that the second stone striking mechanism 40 and the first stone striking mechanism 30 strike the calculus c embedded in the kidney together, the second stone striking mechanism 40 can be extended out from the front end portion 110, the second stone striking mechanism 40 extended out of the front end portion 110 can strike the same position of the calculus c simultaneously with the first stone striking mechanism 30, and can also strike the adjacent position of the calculus c simultaneously, so that the calculus c is more easily struck to be broken, the calculus breaking efficiency can be improved, and the calculus removing efficiency is further improved.

During the process that the second stone striking mechanism 40 and the first stone striking mechanism 30 strike the movable stone together, the movable stone can be struck by the first stone striking mechanism 30 to the laser emitting path of the second stone striking mechanism 40 so as to rapidly break up the movable stone. Specifically, the accessible the portable calculus of laser impact of first stone mechanism 30 outgoing, the portable calculus that receives laser impact move along the J direction to when the laser outgoing route of second stone mechanism 40 is hit on, the second hit the laser of stone mechanism 40 outgoing with the K direction that the J direction becomes the contained angle hits portable calculus and hits for the calculus that moves along the J direction receive in the twinkling of an eye with the force of the K direction that the J direction becomes the contained angle, like this, the calculus is easily beaten the bits fast to improve rubble efficiency. Of course, the second stone striking mechanism 40 can also strike the movable stone to the laser emitting path of the first stone striking mechanism 30 to quickly break up the movable stone.

The first stone striking mechanism 30 and the second stone striking mechanism 40 may be matched in the following manner: the first stone striking mechanism 30 and the second stone striking mechanism 40 firstly strike the stone c in the renal pelvis together; then, when the crushed stones are locked to the suction port 131, the second stone striking mechanism 40 is retracted to the suction port 131 and strikes the stones blocked by the suction port 131.

It should be noted that, in the process of hitting the stones through the first stone hitting mechanism 30 and the second stone hitting mechanism 40, the tube lens main body 10 may be rotated, so that the first stone hitting mechanism 30 and the second stone hitting mechanism 40 may hit the stones in multiple directions, and the fluid exiting from the filling port 121 may comprehensively hit the broken stones around the tube lens main body 10.

In summary, the proximal-distal double-strike ureteroscope 100 and the method for removing stones by using the ureteroscope 100 according to the embodiments of the present application are illustrated, wherein the proximal-distal double-strike ureteroscope 100 can achieve the following effects by adopting a "distal-proximal double-strike" scheme: when the calculus c embedded in the kidney or the movable calculus is hit, the calculus blocked at the suction port of the suction channel is cleaned, so that the calculus removing efficiency is improved.

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 present invention have been fully and effectively accomplished. The functional and structural principles of the present invention have been shown and described in the examples, and any variations or modifications of the embodiments of the present invention may be made without departing from the principles.

Claims (17)

1. A proximal-distal double-strike ureteroscope, comprising:

an operation unit;

a tube lens body having a front end and a rear end, comprising: a tube structure body, at least one irrigation channel extending within the tube structure body from the rear end to the front end, a suction channel within the tube structure body extending from the front end to the rear end, the suction channel having a suction port at the front end, the operating portion being operatively connected to the tube scope body;

a first stone striking mechanism comprising: the first head part protrudes out of the front end part of the tube lens main body and is used for beating calculus; and

a second stone striking mechanism comprising: the second head part of the second stone striking mechanism is positioned at the suction port of the suction channel and is used for striking stones blocked at the suction port.

2. The proximal-distal double tap ureteroscope according to claim 1, wherein the first head of the first tap mechanism is positioned forward of the second head of the second tap mechanism.

3. The proximal-distal double click ureteroscope according to claim 2, wherein the first head is oriented in a first orientation and the second head is oriented in a second orientation, the first and second orientations being at a preset angle, the preset angle being greater than 0 ° and less than 180 °.

4. The proximal-distal double click ureteroscope according to claim 3, wherein the first head of the first click mechanism is not in the laser exit path of the second click mechanism.

5. The proximal-distal double click ureteroscope according to claim 1, wherein the scope body has a front end surface and an outer peripheral surface, the front end surface extending forward from a first side of the outer peripheral surface to a second side opposite to the first side along an axial direction set by the scope body.

6. The proximal-distal double click ureteroscope according to claim 5, wherein the first head extends from the front end face, and any point on the front end face is not in the laser exit path of the first and second click mechanisms.

7. The proximal-distal double click ureteroscope according to claim 1, wherein the first head is movably disposed at the front end to switch between a first state and a second state, wherein the first head extends from the front end to a first position when in the first state, and extends from the front end to a second position when in the second state, and wherein a distance between the first position and the front end is greater than a distance between the second position and the front end.

8. The proximal-distal double-click ureteroscope according to claim 7, further comprising a first optical fiber channel disposed in the ureteroscope body, wherein the first click mechanism is telescopically disposed in the first optical fiber channel, wherein the first optical fiber channel has a first lithotripsy port formed in the front end portion, and wherein the first head portion is disposed in the first optical fiber channel and extends out of the first lithotripsy port.

9. The proximal-distal double-strike ureteroscope according to claim 1, wherein the second head is movably arranged in the suction channel to switch between a third state and a fourth state, the second head extends out of the suction port to strike stones when in the third state, and the second head retracts back to the suction port to strike stones blocked in the suction port when in the fourth state.

10. The proximal-distal double-click ureteroscope according to claim 9, wherein the scope body further comprises a second optical fiber channel communicated with the suction channel, the second stone-hitting mechanism is telescopically arranged in the second optical fiber channel, the second optical fiber channel comprises a main body section and a communication section extending between the main body section and the suction channel, the communication section is communicated with the suction channel and the main body section, and the second head portion extends into the suction channel through the communication section.

11. The proximal-distal double click ureteroscope according to claim 10, wherein the tube structure body has a front end surface and an outer peripheral surface, and the suction port is formed in the front end surface, wherein the front end surface extends obliquely forward along an axial direction set by the tube scope body from a first side of the outer peripheral surface to a second side opposite to the first side.

12. The proximal-distal double click ureteroscope according to claim 11, wherein the angle between the central axis of the communicating section and the central axis of the suction channel is in the range of 0-45 °.

13. The proximal-distal double click ureteroscope according to claim 12, wherein the second click mechanism is located in a middle region of the suction port when the second click mechanism is in the fourth state.

14. The proximal-distal double click ureteroscope according to claim 13, wherein the front end of the second head is flush with the front end face when the second click mechanism is in the fourth state.

15. The proximal-distal double click ureteroscope according to claim 1, further comprising a third stone-hitting mechanism provided to the scope body, comprising: a third head portion and a third body portion extending rearward from the third head portion, the third head portion of the third stone striking mechanism.

16. The proximal-distal double click ureteroscope according to claim 1, wherein the perfusion channel has a perfusion port at the front end portion, the perfusion port of the perfusion channel has a first orientation for allowing fluid to be injected into the renal pelvis from the perfusion port in a first direction directed in the first orientation along the perfusion channel, and the suction port of the suction channel has a second orientation at a preset angle to the first orientation for allowing the fluid to be sucked from the suction port into the suction channel in a second direction directed in the second orientation after being deflected within the renal pelvis to form a fluid loop.

17. A method of removing a stone with a ureteroscope, comprising:

the laser emitted by the first stone hitting mechanism hits the stone;

leading the crushed stones to a suction port of the suction channel through the fluid return ring; and

the laser emitted by the second stone striking mechanism strikes the stones blocked at the suction port, so that the stones blocked at the suction port can be broken and then discharged through the suction port.

Images