CN116172674B - Endoscope integrated with cutting device and cutting device - Google Patents

Endoscope integrated with cutting device and cutting device Download PDF

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Publication number
CN116172674B
CN116172674B CN202310457339.3A CN202310457339A CN116172674B CN 116172674 B CN116172674 B CN 116172674B CN 202310457339 A CN202310457339 A CN 202310457339A CN 116172674 B CN116172674 B CN 116172674B
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Prior art keywords
cutting
endoscope
cutting device
imaging element
driving
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CN202310457339.3A
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CN116172674A (en
Inventor
杨翔
郝进争
王臣峰
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Shanghai Yodo Medical Technology Co ltd
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Shanghai Yodo Medical Technology Co ltd
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Priority to CN202310914986.2A priority Critical patent/CN116807580A/en
Priority to CN202310457339.3A priority patent/CN116172674B/en
Publication of CN116172674A publication Critical patent/CN116172674A/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/42—Gynaecological or obstetrical instruments or methods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/361—Image-producing devices, e.g. surgical cameras
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
    • A61B17/32002—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
    • A61B2017/320028—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments with reciprocating movements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320082—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic for incising tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/42—Gynaecological or obstetrical instruments or methods
    • A61B2017/4216—Operations on uterus, e.g. endometrium
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00559—Female reproductive organs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00601—Cutting
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00982—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A61B2090/373—Surgical systems with images on a monitor during operation using light, e.g. by using optical scanners

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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  • Oral & Maxillofacial Surgery (AREA)
  • Otolaryngology (AREA)
  • Gynecology & Obstetrics (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Mechanical Engineering (AREA)
  • Dentistry (AREA)
  • Physics & Mathematics (AREA)
  • Plasma & Fusion (AREA)
  • Reproductive Health (AREA)
  • Pregnancy & Childbirth (AREA)
  • Radiology & Medical Imaging (AREA)
  • Endoscopes (AREA)

Abstract

The application provides an endoscope integrated with a cutting device and the cutting device. The endoscope includes an operating portion, a scope tube, a head end, and a cutting device. The head end comprises a body, an imaging element and an illumination element; the cutting device comprises two connecting parts, a cutting part and a driving part, wherein the lens tube comprises a hard outer side wall, two guide grooves are formed in the outer side wall along the length direction, the two connecting parts are respectively arranged in the guide grooves in a sliding mode, and the driving part is suitable for driving the two connecting parts to synchronously move so as to drive the cutting part to move back and forth. The endoscope may further comprise an outer sheath, the cutting portion being located in the outer sheath in the contracted state or in a relief portion provided on the head end. The imaging element may be provided rotatably, and the driving section drives the cutting section to move and the imaging element to rotate simultaneously. The cutting device may be provided as a detachable mounted stand-alone module for mounting to the disposable endoscope body. The application integrates the cutting device into the endoscope, thereby improving the operation efficiency and the adaptability of the endoscope.

Description

Endoscope integrated with cutting device and cutting device
Technical Field
The application relates to the technical field of medical instruments, in particular to an endoscope integrated with a cutting device and the cutting device.
Background
Endoscopes are the main stream instruments for therapeutic means such as uterine cavity surgery, and are widely used for diagnosis and minimally invasive treatment. Minimally invasive, accurate and rapid diagnosis and treatment are becoming more and more clinical needs, wherein the requirements of gynecological minimally invasive diagnosis and treatment are most obvious. At the gynecological minimally invasive diagnosis and treatment end, a large number of irregular colporrhagia patients and infertility patients need early detection, early diagnosis and early treatment in each year.
Minimally invasive surgery involves the passage of surgical instruments through an endoscope to a target site for cutting or ablation procedures. Among them, ablation is a minimally invasive surgery which is now common, and can effectively remove the proliferation tissue, benign tumor and malignant tumor. Often, the ablation procedure requires an additional ultrasound guidance system, but the accuracy and intuitiveness of the position feedback of the ultrasound guidance system is poor. Minimally invasive ablation procedures in combination with endoscopes are therefore a better option.
However, in order to enable the surgical instrument to be inserted into the instrument channel of the endoscope, the radial dimension of the endoscope is relatively large, and particularly, the surgical instrument with relatively large dimension in the radial direction of the endoscope such as an electric cutting ring is required to be provided with the large-caliber instrument channel, so that the cost of the endoscope is increased, and meanwhile, the adaptability of the endoscope is reduced.
Disclosure of Invention
In view of the above-mentioned shortcomings of the prior art, it is an object of the present application to provide an endoscope for an integrated cutting device for cutting or ablating a minimally invasive procedure, improving the efficiency of the procedure, reducing the radial dimension of the endoscope, and at the same time, being relatively low in cost, and a cutting device for the endoscope.
In order to achieve the above object, the present application provides the following technical solutions.
An endoscope integrated cutting device, comprising: an operation unit; a scope tube, the proximal end of which is connected to the operation part; a head end connected to a distal end of the lens tube, the head end comprising a body, an imaging element, and an illumination element; a cutting device comprising two connection parts, a cutting part and a driving part, wherein the connection parts connect the cutting part to the driving part; the lens tube comprises a hard outer side wall, two guide grooves are formed in the outer side wall along the length direction, the two connecting portions are respectively arranged in the guide grooves in a sliding mode, and the driving portion is suitable for driving the connecting portions to synchronously move so as to drive the cutting portions to move forwards and backwards.
In some embodiments, the cutting portion is one of an electric cutting ring, a mechanical cutting instrument, a condensing blade, an ultrasonic blade; the cutting portion is biased to one side in the radial direction of the mirror tube.
In some embodiments, two of the guide grooves are disposed opposite each other on both sides of the mirror tube in the radial direction.
In some embodiments, the cutting portion has a contracted state and an operative state; the distal end of the cutting portion in the contracted state does not exceed the distal end of the head end; the cutting part in the working state extends beyond the distal end of the head end.
In some embodiments, an inward concave avoidance portion is disposed on an outer side surface of the head end, and the shape of the avoidance portion is matched with that of the cutting portion, so that the cutting portion is integrally retracted into the avoidance portion to form the contracted state.
In some embodiments, the scope further comprises an instrument channel that is offset to one side of the cutting portion in a radial direction of the scope.
In some embodiments, the cutting portion has a semi-annular structure with both ends connected to distal ends of the two connection portions, respectively, in an axial view of the head end.
In some embodiments, the endoscope further comprises a transmission, a distal end of which is connected to the imaging element; the body having a receiving cavity, the imaging element being hinged to the body so as to be adapted to rotate within the receiving cavity about a first axis of rotation; the connecting point of the transmission piece and the imaging element is far away from the first rotating shaft, and when the transmission piece moves along the length direction of the lens tube, the distal end of the transmission piece drives the imaging element to rotate; the body includes a transparent structure that is disposed in mating relation with the imaging element and the illumination element.
In some embodiments, the imaging element and the illumination element comprise an imaging module; the proximal end of the transmission piece is connected to the driving part, so that the driving part drives the cutting part, and simultaneously drives the transmission piece to adjust the angle of the imaging module, and the angle of the imaging module is matched with the position of the cutting part.
In some embodiments, the endoscope of the integrated cutting device further comprises an outer sheath, the outer sheath being disposed outside the scope; the cutting part in a contracted state is integrally positioned inside the outer sheath, and the cutting part in a working state extends out of the outer sheath.
In some embodiments, the cutting device is detachably mounted, wherein the driving part is detachably mounted to the operating part or the mirror tube; the operation part, the lens tube and the head end are all disposable articles; or, the lens tube is detachably mounted on the operation part, and the lens tube and the head end form a disposable insertion part.
The application also provides a cutting device for mounting to an endoscope, comprising two connecting parts, a cutting part and a driving part, wherein the connecting parts connect the cutting part to the driving part; the endoscope comprises an endoscope tube, a driving part, a cutting part, a guide groove, a connecting part and a connecting part, wherein the outer side wall of the endoscope tube of the endoscope is provided with two guide grooves along the length direction, the two connecting parts are respectively suitable for being arranged in one guide groove in a sliding way, and the driving part is suitable for driving the cutting part to move forwards and backwards through the connecting part.
Various embodiments of the present application have at least one of the following technical effects:
1. the cutting part with larger radial dimension can be arranged outside the endoscope tube of the endoscope in a sliding way through the two guide grooves arranged on the outer side wall of the endoscope tube and the connecting part which is arranged in a matching way, so that the radial dimension of the endoscope tube of the endoscope is smaller;
2. through the arrangement of more than two connecting parts, the posture of the cutting part is stable, and the cutting part can bear larger lateral force, so that the cutting process is more accurate and stable;
3. by arranging the avoiding part at the head end, the cutting part can be hidden into the cross section of the endoscope tube in a contracted state, so that the insertion operation of the endoscope is not affected;
4. by simultaneously arranging the instrument channels with smaller caliber, the auxiliary instrument and the cutting part can be mutually matched to perform more complicated operation, the application range of the endoscope is increased, and the adaptability of the endoscope is improved;
5. by adjusting the angles of the imaging element and the illumination element, better illumination and visual feedback is provided for the surgical procedure; the transmission part for adjusting the angle of the imaging element is connected to the driving part of the cutting device, so that the linkage of the imaging element and the cutting part is realized, better visual feedback can be realized, and the operation comfort and the operation safety are improved;
6. the cutting device can be detachably installed, so that the cutting device can be matched with a disposable endoscope or a disposable insertion part for use, and the comprehensive use cost is reduced.
Drawings
The above features, technical features, advantages and implementation of the present application will be further described in the following description of preferred embodiments with reference to the accompanying drawings in a clear and easily understood manner.
FIG. 1 is a schematic side view of an endoscope of an integrated cutting device of an embodiment;
FIG. 2 is a distal axial view of the embodiment of FIG. 1;
FIG. 3 is a schematic illustration of a cross-section of an insert portion of the embodiment of FIG. 1;
FIG. 4 is a schematic top view of the insert portion of the embodiment of FIG. 1;
FIG. 5 is a schematic view of a cutting portion of one embodiment in a contracted state;
FIG. 6 is a schematic view of the embodiment of FIG. 5 with the cutting portion in an operative condition;
fig. 7 is a perspective view of the headend body of the embodiment of fig. 5;
FIG. 8 is a distal axial view of the embodiment of FIG. 5;
FIG. 9 is a partial cutaway schematic view of a head end position of an embodiment;
FIG. 10 is an enlarged view of portion A of FIG. 9;
FIG. 11 is a variation of the structure of FIG. 10;
FIG. 12 is an adjustment of the structure of FIG. 11;
FIG. 13 is a variation of the structure of FIG. 10;
FIG. 14 is a schematic view of a driving portion structure of an embodiment;
reference numerals illustrate:
100. the tool includes an operating portion, 110, a return tube, 120, an instrument interface, 200, a lens tube, 201, a return orifice, 202, a return passage, 203, a guide slot, 204, an instrument passage, 205, a return interface, 300, a head end, 302, a receiving cavity, 303, a relief portion, 304, a head end guide slot, 310, a body, 311, a transparent cover, 320, an imaging element, 321, a third lug, 322, a first lug, 3221, a guide slot, 323, a pin, 324, a second lug, 330, an illumination element, 400, a cutting device, 410, a connecting portion, 420, a cutting portion, 430, a driving portion, 431, a handle, 500, an elastic element, 600, and a transmission element.
Detailed Description
In order to more clearly illustrate the embodiments of the present application or the technical solutions in the prior art, the following description will explain specific embodiments of the present application with reference to the accompanying drawings. The drawings in the following description are only examples of the present application and other drawings and other embodiments may be obtained from these drawings by those skilled in the art without undue effort.
For the sake of simplicity of the drawing, the parts relevant to the present application are shown only schematically in the figures, which do not represent the actual structure thereof as a product. In some of the figures, only one of which is schematically depicted, or only one of which is labeled, components having the same structure or function. Herein, "a" means not only "only this one" but also "more than one" case. The term "and/or" as used in the present specification and the appended claims refers to any and all possible combinations of one or more of the associated listed items, and includes such combinations. The terms "first," "second," and the like are used merely to distinguish between descriptions and are not to be construed as indicating or implying relative importance.
Unless specifically stated or limited otherwise, the terms "mounted," "connected," and "coupled" are to be construed broadly, and may be, for example, fixedly connected, detachably connected, or integrally connected; can be mechanically or electrically connected; can be directly connected or indirectly connected through an intermediate medium, and can be communication between two elements. The specific meaning of the above terms in the present application will be understood in specific cases by those of ordinary skill in the art.
Embodiment one. As shown in fig. 1, the present embodiment is an endoscope integrated with a cutting device, including an operation part 100, a scope tube 200, a head end 300, and a cutting device 400. The proximal end of the scope 200 is connected to the operation section 100; the head end 300 is connected to the distal end of the scope 200. As shown in fig. 2, the head end 300 includes a body 310, an imaging element 320, and an illumination element 330. As shown in fig. 1 and 2, the cutting device 400 includes two connection parts 410, a cutting part 420, and a driving part 430, the connection parts 410 connecting the cutting part 420 to the driving part 430; the lens tube 200 includes a rigid outer sidewall, two guide grooves 203 are disposed on the outer sidewall along a length direction, two connecting portions 410 are slidably disposed in the guide grooves 203, and the driving portion 430 is adapted to drive the connecting portions 410 to move synchronously, so as to drive the cutting portion 420 to move back and forth.
The cutting device 400 of the present embodiment is an electric cutter, and the cutting portion 420 is an electric cutting ring. The electric cutting ring and the auxiliary electrode can form a monopolar electric cutting knife, or bipolar electric cutting rings are adopted, and the bipolar electric cutting ring can be used for electric cutting ablation operation. As shown in fig. 14, the driving part 430 includes a handle 431 provided to be hinged, the connection part 410 is slidably connected to the handle 431, and an operator pushes and pulls the connection part 410 by operating the handle 431 to realize a driving function. The operation section 100 includes an electrical interface and a return pipe 110, and the wiring harness of the imaging element 320 and the illumination element 330 is connected to the electrical interface of the operation section 100; a plurality of reflux holes 201 are arranged on the side wall of the distal end of the mirror tube 200, and reflux liquid flows back to a recovery system which is arranged in a matched mode through the reflux pipe 110 after entering a reflux channel 202 of the mirror tube 200 through the reflux holes 201.
As shown in fig. 2, the cutting portion 420 is biased to one side in the radial direction of the scope 200, and the two guide grooves 203 are provided opposite to each other on both sides in the radial direction of the scope 200. However, both guide grooves 203 may be provided on one side in the radial direction of the scope 200, that is, the interval between the two guide grooves 203 in the circumferential direction may be smaller than 180 °. The cutting part 420 may also be formed in a complete ring shape so as to be circumferentially symmetrically arranged in the radial direction of the scope 200. In the axial view of the head end 300, as shown in fig. 2, the cutting part 420 has a projection of a semi-ring structure, and both ends of the semi-ring structure are respectively connected to distal ends of the two connection parts 410. From other viewpoints, as shown in fig. 3, the cutting portion 420 is located on the same plane in the axial direction of the scope 200; however, the cutting portion 420 may be provided in other suitable configurations, for example, in the view of fig. 3, the cutting portion 420 may have an axial dimension, thereby forming an oval spade-like profile; or the cutting portion 420 may include a distally extending needle-like structure. Since the cutting part 420 is connected to the two connecting parts 410, it has excellent shape stability, can withstand large lateral force, and is advantageous for accurately and stably performing the cutting operation.
As a variation of this embodiment, the cutting portion 420 may also be a mechanical cutting instrument, and together with the two connecting portions 410, form a spatula-like structure, which may be used for simple cutting and cleaning surgical operations; the cutting part 420 may also be a condensing knife, such as a needle-shaped condensing knife, for penetrating the tissue to perform a cryoablation operation, and the two connecting parts 410 may be provided as hollow structures for forming a condensed gas-liquid circuit; the cutting portion 420 may also be other miniature cutting instruments such as ultrasonic blades. As shown in fig. 7, when necessary, for example, when the connection portion 410 and the head end 300 may interfere, a head end guide groove 304 may be provided on the body 310 of the head end 300, and the guide groove 203 together constitute a sliding guide structure of the connection portion 410.
The driving part 430 may also be a knob to realize screw driving, and the driving part 430 may also include a micro motor and a transmission mechanism to realize electric driving. The connection portion 410 may be further provided in a plurality, for example, 3, to form a more stable three-dimensional support structure for the cutting portion 420. As shown in fig. 5, the scope 200 and the head 300 may further be provided with an instrument channel 204, and the operation portion 100 includes an instrument interface 120, where the instrument interface 120 and the instrument channel 204 are matched and configured to wear an auxiliary instrument to perform a surgical operation in cooperation with the cutting device 400. The instrument channel 204 may also be used to deliver irrigation fluid when no additional irrigation channels or irrigation tubing are provided. As shown in FIG. 5, the instrument channel 204 is preferably positioned offset to one side of the cutting portion 420 to facilitate the mating operation of the auxiliary instrument and the cutting portion 420, but other arrangements may be used if desired, such as the positions of the instrument channel 204 and the imaging member 320 in FIG. 5 may be interchanged.
Embodiment two. On the basis of the first embodiment, this embodiment provides a specific arrangement manner of the cutting portion 420. As shown in fig. 5 and 6, the cutting part 420 has a contracted state and an operating state; wherein the distal end of the cutting portion 420 in the contracted state does not exceed the distal end of the head end 300, as shown in fig. 5; as shown in fig. 6, the active cutting portion 420 extends beyond the distal end of the head end 300. The driving part 430 drives the cutting part 420 to move between the contracted state and the working state through the connection part 410, and to move back and forth in the working state to perform the cutting operation.
As shown in fig. 7, the head end 300 has a cylindrical shape as a whole, and has a radially inward recessed escape portion 303 provided on a side surface thereof, and the escape portion 303 is formed in a shape matching with the cutting portion 420 so that the cutting portion 420 is retracted into the escape portion 303 as a whole, thereby forming a contracted state shown in fig. 5. The arrangement makes the shape of the front end of the insertion part of the endoscope regular, and the insertion operation is easy. When the distal end face of the head end 300 has a sufficient arrangement space, for example, when the instrument channel 204 is not provided in fig. 5, the avoidance portion 303 may be concavely provided on the distal end face of the head end 300, and the cutting portion 420 may be integrally retracted into the avoidance portion 303 without exceeding the distal end face of the head end 300.
Embodiment three. On the basis of the above embodiment, the present embodiment includes the imaging element 320 whose angle can be adjusted. As shown in fig. 9, the endoscope further includes a transmission 600, the distal end of the transmission 600 being connected to the imaging element 320; the body 310 has a receiving cavity 302, and the imaging element 320 is hinged to the body 310 so as to be adapted to rotate within the receiving cavity 302 about a first axis of rotation; the connection point of the transmission piece 600 and the imaging element 320 is far away from the first rotating shaft, and when the transmission piece 600 moves along the length direction of the lens tube 200, the distal end of the transmission piece 600 drives the imaging element 320 to rotate; the body 310 includes a transparent structure that is disposed in mating relationship with the imaging element 320 and the illumination element 330.
The transparent structure of the present embodiment includes the hemispherical shell-shaped transparent cover 311 in fig. 9, so that the imaging element 320 can shoot through the transparent structure in any posture; the transparent structure also ensures that the illumination element 330 can provide illumination to the site to be observed or operated upon when the illumination element 330 is also positioned within the receiving cavity 302; when the lighting element 330 is not disposed within the receiving cavity 302, the transparent structure includes a protective structure, such as a transparent headend end cap, that covers the distal end of the lighting element 330. The proximal end of the transmission member 600 may be provided with an operating member such as an adjusting handle or knob alone for adjustment or connected to the driving part 430 of the cutting device 400.
As shown in fig. 10, the hinged connection allows imaging member 320 to be adapted to rotate about a first axis of rotation within receiving chamber 302. The first axis of rotation, not shown, may be formed by a third lobe 321 on the imaging element 320 shown. The connection point of the transmission member 600 and the imaging element 320 is away from the first rotation axis, so that the force applied to the imaging element 320 by the transmission member 600 has a moment arm relative to the first rotation axis, and the transmission member 600 can apply a torque about the first rotation axis to the imaging element 320. When the operating member such as the adjusting handle controls the driving member 600 to move along the length direction of the lens tube 200, the distal end of the driving member 600 drives the imaging element 320 to rotate around the first rotation axis. The first axis of rotation of this embodiment is perpendicular or substantially perpendicular to the axis of the mirror tube 200. The lens tube 200 of the present embodiment may be manufactured by extrusion molding or integral injection molding.
The transmission member 600 penetrates the return passage 202 from the operation portion 100 through the seal penetration structure, and penetrates the body 310 through the seal structure in the return passage 202, and then enters the accommodating chamber 302. The return passage 202 serves as an arrangement passage for both the transmission 600 and the harness of the head 300, in which case the harness of the head 300, such as the harness of the imaging element 320 and the lighting element 330, needs to employ a watertight cable, while the transmission 600 and the body 310 of the head 300 need to be provided in a sealed sliding structure.
As shown in fig. 11 and 12, when the imaging element 320 rotates, its photographing direction rotates toward or away from the side of the cutting part 420, i.e., the first rotation axis is substantially parallel to the plane formed by the two connection parts 410, so that the imaging element 320 can adjust visual feedback to the cutting part 420 moving back and forth. A transmission member penetrating channel may be specially provided in the lens tube 200 for the transmission member 600, for penetrating the transmission member 600 and the wire harness of the head end 300. At this time, the driving member 600 penetrates into the driving member penetrating channel from the operation part 100, penetrates into the body 310 through the driving member penetrating channel, and then enters the accommodating cavity 302 to be connected to the imaging element 320, and at this time, a sealing sliding structure is not required to be arranged between the driving member 600 and the operation part 100, and between the driving member 600 and the head end 300.
The imaging element 320 may be formed by a lens and a CCD or CMOS photosensitive chip, and the miniaturization of the structure has been achieved so far, so that it is possible to rotatably arrange the imaging element 320 in the accommodating cavity 302 of the head end 300 according to the present application. The lighting element 330 of fig. 2 and 8 may be a white LED, may be easier and less costly to arrange than an optical fiber, and may be a small-sized element. As a variation of this embodiment, the illumination element 330 may also be fixed to the imaging element 320 in the accommodating cavity 302, and form an imaging module together with the imaging element 320, so as to rotate together with the imaging element 320, so that the shooting target of the imaging element 320 is always well illuminated.
In this embodiment, by setting the imaging element 320 rotatable, in cooperation with the overall rotation of the scope tube 200 and the endoscope, the endoscope can obtain a more comprehensive and clear view in a limited space without bending the scope tube 200, and the view is adjusted according to the movement of the cutting portion 420, so as to achieve better visual feedback. And the adjusting structure of the imaging element 320 is simple and reliable, the cost is low, and the operation is simple and convenient.
There are a variety of specific ways in which the transmission 600 and imaging element 320 may be connected. As shown in fig. 9 and 10, the imaging element 320 has two third lugs 321 protruding from both sides, and the third lugs 321 are rotatably disposed in shaft holes on the body 310 to form a first rotation axis together, so that the imaging element 320 can rotate around the first rotation axis. The transmission member 600 in fig. 10 is a link rod having elasticity. The transmission member 600 penetrates into the accommodating cavity 302 through the reflux passage 202 of the lens tube 200 or the transmission member penetrating passage, and is slidably penetrating into the body 310, and the imaging element 320 can be driven to rotate by pushing and pulling the connecting rod. The imaging element 320 is generally cylindrical in shape as a whole, and is further provided with a first lug 322 on a side offset from the two third lugs 321 by a quarter of a circumference, and the distal end of the link, i.e., the transmission 600, is rotatably connected to the first lug 322 by a pin 323. When the transmission member 600 is pushed and pulled, the transmission member 600 can apply a torque to the imaging element 320 to rotate around the first rotation axis formed by the third lug 321.
When the transmission member 600 is sealingly and slidably disposed on the body 310, the radial distance between the pin 323 and the axis of the lens tube or the third lug 321 may be changed when the transmission member 600 moves back and forth to rotate the imaging element 320, so that the transmission member 600 is elastically disposed and may be made of a thin metal rod or a plastic rod, for example. When the transmission member penetrating passage is provided, the transmission member 600 may be provided as a rigid metal link since the transmission member 600 and the transmission member penetrating passage do not need to be slidably fitted to form a sealing structure. The third lug 321 engages with a shaft hole in the body 310 to form a hinge structure, but may be implemented in other ways, for example, by a protrusion provided in the body 310 engaging with a shaft hole provided in the imaging element 320, or by a pin penetrating the imaging element 320 and the body 310.
As shown in FIG. 11, the first lug 322 has a sliding groove 3221, and the connecting rod, i.e. the distal end of the transmission member 600, is hung in the sliding groove 3221, so that the distal end of the transmission member 600 can slide back and forth in the sliding groove 3221 along the length direction of the sliding groove 3221. Specifically, the distal end of the transmission member 600 has a bending structure, so that a small section of the transmission member 600 is inserted into the chute 3221 along the thickness direction of the first lug 322, i.e. the direction of the first rotation axis.
The advantage of the above arrangement is that, as shown in fig. 12, when the transmission member 600 is slidably and sealingly disposed on the body 310, the distal end of the transmission member 600 can slide back and forth in the sliding groove 3221 when the transmission member 600 moves in the front-back direction (i.e., the left-right direction in the drawing), so as to avoid the unsmooth front-back movement of the transmission member 600 caused by the lateral force, and further affect the smooth progress of the angle adjustment of the imaging element 320. By the arrangement of the chute 3221, the rotation range of the imaging element 320 can be made to be more than 90 degrees.
As shown in fig. 11, an elastic member 500 may also be provided for the imaging element 320. Specifically, the imaging element 320 has a first lug 322 and a second lug 324 that are disposed opposite each other on both sides of a first rotation axis formed by the third lug 321, or the first lug 322 and the second lug 324 are disposed opposite each other on a side surface that is offset from the third lug 321 by 90 degrees in the circumferential direction. The second lug 324 is connected to the body 310 by a resilient member 500 that is always tensioned, and the resilient member 500 may be implemented as a coil spring or reed. The driving member 600 pulls or pushes the first lug 322 to rotate the imaging member 320 while also further tensioning or releasing the elastic member 500. The elastic member 500 can eliminate the gap between the transmission member 600 and the imaging element 320, and avoid shaking and instability during rotation of the imaging element 320 and after adjustment.
Another advantage of providing the resilient member 500 is that the manner of connection of the transmission member 600 and the imaging element 320 may be more flexible, e.g., the transmission member 600 need only push or pull the imaging element 320 via surface contact, rather than being hinged via the pin 323, nor being able to hang the transmission member 600 into the chute 3221.
In addition, as shown in fig. 13, the transmission member 600 may be provided as a cable made of a wire rope. Specifically, the number of the two cables is two, and the connection points of the two cables and the imaging element 320 are far away from each other and far away from the first rotation shaft. The imaging element 320 is rotated by pulling the cable on one side. The cable may be connected to a first lug 322 and a second lug 324, respectively, disposed opposite sides of the imaging element 320. The connection between the cable and the operating element of the operating unit 100 is conventional, and is usually performed in an endoscope provided with a bendable tube, and therefore, will not be described in detail. The number of cables may also be one, connected to the first lug 322 of the imaging element 320; meanwhile, the second lug 324 of the imaging element 320 is further connected to the body 310 by a resilient member 500 that is always tensioned, and in particular, a coil spring as shown in fig. 11 may be used as the resilient member 500, and the connection structure may also be provided with reference to fig. 11. Pulling the cable to rotate the imaging element 320 can further tension the elastic member 500; when the cable is released, the return force of the elastic member 500 rotates the imaging element 320 in the opposite direction.
The cable may also be comprised of a bundle of imaging elements 320 or a bundle of illumination elements 330 or a combination thereof. Since the adjustment torque required for the imaging element 320 is small, a portion of the harness of the imaging element 320 or the illumination element 330 may be formed as a wire rope with an insulating outer layer and mechanically connected between the proximal end of the imaging element 320 and the operating member to function as a pulling cable.
Of course, when the imaging element 320 is a wide angle lens, the distal end of the transmission member 600 may be connected to the illumination element 330, and the illumination element 330 is disposed in the accommodating cavity 302, and the illumination element 330 is hinged to the body 310 so as to be adapted to rotate around the second rotation axis in the accommodating cavity 302; the connection point of the transmission member 600 and the lighting element 330 is far away from the second rotation axis, and when the operation member controls the transmission member 600 to move along the length direction of the lens tube 200, the distal end of the transmission member 600 drives the lighting element 330 to rotate. That is, the imaging element 320 may be fixedly disposed, while the illumination element 330 may be rotatably disposed, so that the cutting portion 420, which is moved, may be illuminated in an azimuth that needs to be emphasized within a larger photographing range of the imaging element 320. Of course, if necessary, the imaging element 320 and the illumination element 330 may be rotatably adjustable, so as to obtain a more flexible shooting field of view and illumination effect.
Example four. On the basis of the third embodiment, this embodiment provides a technical solution for linkage between the transmission member 600 and the connecting portion 410. As shown in fig. 14, the driving part 430 of the present embodiment includes a handle 431, the handle 431 is hinged at a point B in the drawing, the proximal end of the transmission member 600 (not shown in fig. 14) is connected to a point D of the handle 431, and the connecting part 410 is connected to a point C of the handle 431, so that when the operator operates the handle 431 to drive the cutting part 420 to move, the transmission member 600 is driven to adjust the angle of the imaging element 320 or the imaging module formed by the imaging element 320 and the illumination element 330 together. By reasonably setting the relative positions of the point B, the point C and the point D, the angle of the imaging element 320 or the imaging module can be matched with the position of the cutting part 420; specifically, as the cutting portion 420 moves back and forth, the imaging element 320 or imaging module adjusts the angle accordingly, such that the imaging element 320 and the illumination element 330 are always oriented generally toward the cutting portion 420 or the site to be cut. When the driving part 430 adopts other operation modes such as a knob, a motor and the like, the transmission member 600 and the connecting part 410 can be correspondingly set into a linkage mode, and the expansion is not performed.
Example five. On the basis of the above embodiments, the present embodiment further includes an outer sheath, and the outer sheath is sleeved outside the scope tube 200; the contracted state of the cutting portion 420 is entirely located inside the outer sheath, and the working state of the cutting portion 420 extends out of the outer sheath. The provision of the outer sheath, while increasing the radial dimension of the endoscope insertion portion, may increase the flexibility of the structural arrangement of the scope tube 200 and the connecting portion 410, for example, may be used for hysteroscopes where the radial dimension of the insertion portion is not particularly sensitive.
Example six. On the basis of the above embodiments, the cutting device 400 of the present embodiment is detachably mounted, wherein the driving part 430 is detachably mounted to the proximal end of the operating part 100 or the scope 200; the operation part 100, the lens tube 200 and the head end 300 are all disposable articles; alternatively, the scope 200 is detachably attached to the operation portion 100, and the scope 200 and the head end 300 constitute a disposable insertion portion. As shown in fig. 3, the mirror tube 200 may communicate its return channel 202 to the return tube 110 of the operation portion 100 via a return interface 205. As shown in fig. 4 and 5, the connection part 410 and the cutting part 420 may be inserted into the guide groove 203 from the distal end of the scope 200 first, and then the connection part 410 and the driving part 430 may be connected; or the structure of the connection part 410 and the cutting part 420 is provided as an elastic structure, so that the connection part 410 can be mounted into the guide groove 203 from the side of the scope tube 200 by using its elastic deformation.
Yet another advantage of providing the cutting device 400 as a removable unit is that a different cutting device 400 can be replaced when the endoscope body is not disposable. For example, a series of cutting devices 400 may be provided that can be selectively mounted to a certain model of endoscope body, thereby further increasing the applicability of the endoscope.
Example seven. The present embodiment is a cutting device 400 for mounting to an endoscope. Referring to fig. 1 and 2, the present embodiment includes two connection parts 410, a cutting part 420, and a driving part 430, the connection parts 410 connecting the cutting part 420 to the driving part 430; wherein, two guide grooves 203 are arranged on the outer side wall of the endoscope tube along the length direction, two connecting parts 410 are respectively arranged in one guide groove 203 in a sliding way, and the driving part 430 is suitable for driving the cutting part 420 to move back and forth through the connecting parts 410. The endoscope may be a disposable instrument except for the structure of the cutting device 400, and the cutting device 400 is detachably mounted to the endoscope.
The cutting device 400 of this embodiment corresponds to the cutting device 400 of any of the previous embodiments, but is developed and produced as a stand-alone module. Because the design, production and related techniques of the cutting device 400 are relatively independent, they can be developed and produced as a single module and can be configured as a series of different types and sizes to selectively install the endoscope that constitutes the integrated cutting device of the foregoing embodiment as needed and to replace it as needed.
The foregoing description is only of the preferred embodiments of the application and the technical principles employed, and various obvious changes, readjustments and substitutions may be made without departing from the spirit of the application. Additional advantages and effects of the present application will be readily apparent to those skilled in the art from the disclosure herein. The application may be practiced or carried out in other embodiments and details within the scope and range of equivalents of the specific embodiments and ranges of equivalents, and modifications and variations may be made in the practice of the application without departing from the spirit or scope of the application. The above embodiments and features of the embodiments may be combined with each other without conflict.

Claims (9)

1. An endoscope integrated with a cutting device, comprising:
an operation unit;
a scope tube, the proximal end of which is connected to the operation part;
a head end connected to a distal end of the lens tube, the head end comprising a body, an imaging element, and an illumination element;
a cutting device comprising two connection parts, a cutting part and a driving part, wherein the connection parts connect the cutting part to the driving part;
the lens tube comprises a hard outer side wall, two guide grooves are formed in the outer side wall along the length direction, two connecting parts are respectively arranged in the guide grooves in a sliding mode, and the driving part is suitable for driving the connecting parts to synchronously move so as to drive the cutting part to move forwards and backwards;
the endoscope further includes a transmission having a distal end connected to the imaging element;
the body has a receiving cavity, and the imaging element is hinged to the body, so that the imaging element is suitable for rotating around a first rotating shaft in the receiving cavity; the connecting point of the transmission piece and the imaging element is far away from the first rotating shaft, and when the transmission piece moves along the length direction of the lens tube, the distal end of the transmission piece drives the imaging element to rotate; the body comprises a transparent structure, and the transparent structure is matched with the imaging element and the illumination element;
the imaging element and the illumination element form an imaging module;
the proximal end of the transmission piece is connected to the driving part, so that the driving part drives the transmission piece to adjust the angle of the imaging module when driving the cutting part, and the angle of the imaging module is matched with the position of the cutting part;
specifically, the drive portion includes the handle that articulates the setting, the proximal end of driving medium is connected to the handle, connecting portion also connect in the handle, through setting up the articulated point of handle, the tie point of driving medium, the tie point three's of connecting portion relative position makes imaging module's angle with the position of cutting portion matches.
2. An endoscope integrated cutting device according to claim 1 and wherein,
the cutting part is one of an electric cutting ring, a mechanical cutting instrument, a condensing knife and an ultrasonic knife;
the cutting portion is biased to one side in the radial direction of the mirror tube.
3. An endoscope integrated cutting device according to claim 1 and wherein,
the two guide grooves are oppositely arranged at two sides of the diameter direction of the lens tube.
4. An endoscope integrated cutting device according to claim 1 and wherein,
the cutting part has a contracted state and a working state; the distal end of the cutting portion in the contracted state does not exceed the distal end of the head end; the cutting part in the working state extends beyond the distal end of the head end.
5. An integrated cutting device endoscope according to claim 4 and wherein,
the outer side surface of the head end is provided with an inward concave avoiding part, the shape of the avoiding part is matched with that of the cutting part, and the cutting part is in a contracted state when integrally retracted into the avoiding part.
6. An endoscope of an integrated cutting device according to claim 2, wherein,
the scope also includes an instrument channel that is offset to one side of the cutting portion in a radial direction of the scope.
7. An endoscope of an integrated cutting device according to any of claims 1 to 6,
at the axial view of the head end, the cutting part is provided with a semi-annular structure, and two ends of the semi-annular structure are respectively connected to the distal ends of the two connecting parts.
8. An endoscope of an integrated cutting device according to any of claims 1 to 6,
the endoscope also comprises an outer sheath, wherein the outer sheath is sleeved outside the endoscope tube;
the cutting part in a contracted state is integrally positioned inside the outer sheath, and the cutting part in a working state extends out of the outer sheath.
9. An endoscope of an integrated cutting device according to any of claims 1 to 6,
the cutting device is detachably mounted, wherein the driving part is detachably mounted on the operating part or the lens tube;
the operation part, the lens tube and the head end are all disposable articles; or, the lens tube is detachably mounted on the operation part, and the lens tube and the head end form a disposable insertion part.
CN202310457339.3A 2023-04-26 2023-04-26 Endoscope integrated with cutting device and cutting device Active CN116172674B (en)

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Denomination of invention: An endoscope and cutting device with integrated cutting device

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