CN116269636B - Stone extractor for hepatobiliary surgery - Google Patents

Stone extractor for hepatobiliary surgery Download PDF

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Publication number
CN116269636B
CN116269636B CN202310182504.9A CN202310182504A CN116269636B CN 116269636 B CN116269636 B CN 116269636B CN 202310182504 A CN202310182504 A CN 202310182504A CN 116269636 B CN116269636 B CN 116269636B
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China
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stone
arc
pipe
tube
shaped pipe
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CN202310182504.9A
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Chinese (zh)
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CN116269636A (en
Inventor
赵磊
尤芷萱
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Guangzhou Medical University
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Guangzhou Medical University
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
    • A61B17/22022Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement using electric discharge
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22031Gripping instruments, e.g. forceps, for removing or smashing calculi
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22031Gripping instruments, e.g. forceps, for removing or smashing calculi
    • A61B2017/22035Gripping instruments, e.g. forceps, for removing or smashing calculi for retrieving or repositioning foreign objects
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22079Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with suction of debris
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y02TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
    • Y02ATECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
    • Y02A50/00TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
    • Y02A50/30Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change

Abstract

The application discloses a stone extractor for hepatobiliary surgery, and relates to the technical field of medical appliances; comprising the following steps: the stone taking pipe can rotate along the axis of the stone taking pipe, the inner wall of the stone taking pipe is provided with a convex rib, and the convex rib is spirally arranged along the axis of the stone taking pipe; one end of the arc-shaped pipe is sleeved outside the stone taking pipe, and the other end of the arc-shaped pipe is connected with a negative pressure source; chu Danguan, which is communicated with the arc-shaped pipe, and the joint of Chu Danguan and the arc-shaped pipe is positioned on the vault section of the arc-shaped pipe and is arranged on the same side as the stone taking pipe; the stone blocking plate is positioned in the arc-shaped pipe and is matched with the cross section of the arc-shaped pipe, the stone blocking plate can breathe, and the stone blocking plate is positioned at the rear side of Chu Danguan; the broken stone electrode is arranged in the arc-shaped pipe in a penetrating way, and the working end of the broken stone electrode protrudes out of one side of the stone baffle plate, which is opposite to the storage Dan Guan; under the conditions that the stone taking pipe rotates and the arc pipe is connected with a negative pressure source, gall stones can be conveyed into the arc pipe and blocked by the stone blocking plate, and stone particles crushed by the stone blocking electrode can fall into the storage Dan Guan. The application can continuously carry out stone extraction and reduce the difficulty of stone extraction.

Description

Stone extractor for hepatobiliary surgery
Technical Field
The application relates to the technical field of medical instruments, in particular to a stone extractor for hepatobiliary surgery.
Background
Along with improvement of living standard, adjustment of dietary structure, gradual popularization of physical examination and the like of people, the cholecystolithiasis gradually increases in prevalence rate in China, and the prevalence rate reaches more than 10%, so that the cholecystolithiasis becomes common and frequently-occurring diseases in China. For the treatment of gall-stone, there are two main schemes, one is to directly cut gall-stone and the other is to take stone to protect gall-stone. However, when the gall bladder is used for digesting food, the gall bladder can play a good role in regulating so as to avoid dyspepsia and bile reflux, and simultaneously has the role in regulating the balance of the pressure in the bile duct, so that the incidence rate of choledocholithiasis is reduced, the gall bladder is an important organ of a human body, the function of the organ is required to be protected to the greatest extent, and direct excision (for those with acute inflammation attack of the gall bladder calculus, no function of the gall bladder, gall bladder occlusion and gall bladder atrophy, and gall bladder calculus is too large or full of calculus and gall bladder silt-like calculus) is avoided as much as possible, so that the gall bladder protecting operation is not suitable. The gallbladder-protecting stone extraction is to extract stones under direct vision, so that the stones can be completely extracted, the recurrence caused by stone residues is avoided, and serious complications and death cases are not yet seen. Therefore, in clinical treatment, patients with gall stones are increasingly being used.
The gall-stone is divided into single gall-stone and multiple gall-stone, the size of the gall-stone is about several millimeters to two centimeters, and the gall-stone and the single gall-stone with large size can be easily taken out by directly adopting a stone-taking forceps or a basket wire. However, for multiple gall stones with smaller size, the gall stones are not easy to clamp and take out one by one, the stone taking efficiency is low, the stone taking time is long, medical staff is in a highly concentrated and highly stressed state in the stone taking process, the physical consumption is high, the falling condition easily occurs in the stone taking process, and the pain of patients is increased.
Disclosure of Invention
Aiming at the technical problem that the existing stone extractor for hepatobiliary surgery can only extract stones one by one; the application provides a stone extractor for hepatobiliary surgery, which can continuously extract stones, reduce the difficulty of stone extraction, and avoid gall stones from falling off in the stone extraction process, thereby reducing the operation burden of medical staff and relieving the pain of patients.
The application is realized by the following technical scheme:
the application provides a stone extractor for hepatobiliary surgery, which comprises: the stone taking pipe can rotate along the axis of the stone taking pipe, and at least one rib is arranged on the inner wall of the stone taking pipe and spirally arranged along the axis of the stone taking pipe; one end of the arc-shaped pipe is sleeved outside the stone removing pipe, and the other end of the arc-shaped pipe is used for connecting a negative pressure source; chu Danguan, which is communicated with the arc-shaped pipe, wherein the joint of the Chu Danguan and the arc-shaped pipe is positioned on the vault section of the arc-shaped pipe along the length direction of the connecting pipe, and the Chu Danguan and the stone removing pipe are arranged on the same side; the baffle plate is positioned in the arc-shaped pipe and is matched with the section of the arc-shaped pipe, the baffle plate can breathe, and the baffle plate is positioned at the rear side of Chu Danguan along the length direction of the connecting pipe; the broken stone electrode is arranged in the arc-shaped pipe in a penetrating way, and the working end of the broken stone electrode protrudes out of one side of the broken stone plate, which is opposite to the Chu Danguan side; the rotary driving assembly is in transmission connection with the stone removing pipe and is used for driving the stone removing pipe to rotate along the axis of the stone removing pipe; under the conditions that the stone taking pipe rotates and the arc-shaped pipe is connected with a negative pressure source, gall-stone can be conveyed into the arc-shaped pipe along the axial direction of the stone taking pipe and blocked by the stone blocking plate, and stone particles crushed by the stone blocking electrode can fall into the Chu Danguan.
According to the stone extractor, the protruding edges are spirally arranged in the stone extracting pipe capable of rotating along the axis of the stone extracting pipe, one end of the stone extracting pipe is connected with one end of the arc-shaped pipe, and the other end of the arc-shaped pipe can be connected with a negative pressure source; before the stone taking operation, connecting the arc-shaped pipe with a negative pressure source so as to continuously provide negative pressure for the stone taking pipe, and connecting the stone breaking electrode with a corresponding driving module; during the stone extraction operation, one end of the stone extraction pipe is covered outside the stones, the stones are sucked through negative pressure and conveyed through the convex edges, so that the stones are conveyed into the arc-shaped pipe and blocked by the stone blocking plate, the stones are broken through the stone blocking electrode, and the negative pressure source is disconnected, so that the broken stones fall into the stone storage pipe under the action of gravity, and the stones are prevented from being blocked in the arc-shaped pipe to influence the suction of the next stones; and then, the next stone can be sucked only by communicating the negative pressure source again, so that the continuous taking out of multiple stones is realized, the stone taking efficiency is improved, and the stone taking operation time is shortened.
Wherein, for the stone with smaller grain diameter and small adhesive force, the stone can be directly sucked into the stone taking pipe under the action of negative pressure, then sent into the arc pipe under the combined action of the negative pressure and the convex edge, and finally adsorbed on the stone blocking plate through the negative pressure. And for stones with larger particles or larger adhesive force, the stone taking pipe can be moved to enable the stones to be in contact with the convex edges in the stone taking pipe, so that the stones are unscrewed from the gall bladder wall through the relative rotation of the convex edges and the stones, then the stones are sent into the arc-shaped pipe through the stone taking pipe under the combined action of negative pressure and the convex edges, and finally are adsorbed on the stone blocking plate through the negative pressure. Therefore, the utility model can meet the common calculus removing requirement, and is suitable for most liver and gall time removing surgical operations.
Meanwhile, in the stone taking process, only the stone taking pipe is required to be aligned with the stones, the negative pressure source continuously provides negative pressure, and the convex edges keep a rotating state, so that the stones entering the stone taking pipe can be prevented from falling off again. In the stone breaking process, the generated small-size stone breaking is stuck to the stone blocking plate under negative pressure suction, so that the risk of clamping and breaking the stone and falling the stone does not exist, the operation difficulty is low, the requirement on medical staff is low, and the physical and mental loss of the medical staff can be reduced.
In addition, in the whole stone extraction process, only the stone extraction pipe is required to be inserted into a patient, the stone extraction pipe does not have an opening and closing structure, the size is small, the size is not enlarged, and compared with the stone extraction forceps or basket wires, the size of an incision in the abdomen of the patient can be reduced, and the operation is more minimally invasive.
In conclusion, the stone extractor for hepatobiliary surgery provided by the application can continuously extract stones, reduce the difficulty of stone extraction, and avoid gall stones from falling off in the stone extraction process, thereby reducing the operation burden of medical staff and relieving the pain of patients.
In an optional embodiment, the stone removing pipe is internally provided with at least one clamping groove, the clamping groove is spirally arranged along the axis of the stone removing pipe, and the convex rib is clamped in the clamping groove so as to reliably install the convex rib on the stone removing pipe wall, and the installation is simple and convenient relative to welding and bonding.
In an alternative embodiment, one end of the arc-shaped pipe is a straight pipe section, and the stone removing pipe is rotatably inserted in the straight pipe section so as to reliably connect the arc-shaped pipe and the stone removing pipe.
In an optional embodiment, the rotary driving assembly comprises a stator ring and a rotor ring, the stator ring is coaxially fixed outside the straight pipe section, the rotor ring is coaxially fixed outside the stone removing pipe, and the stator ring is coaxially sleeved outside the rotor ring so as to form a direct driving motor through the stator ring and the rotor ring, and the stone removing pipe is directly driven to rotate, so that the rotary stone removing device is simple in structure, a transmission part is omitted, the stone removing pipe rotates stably, and the weight of the stone removing device is small.
In an optional embodiment, the device further comprises a protective tube shell, the protective tube shell is sleeved outside the stone removing tube, one end of the protective tube shell is fixedly connected with the stator ring, and a gap is formed between the protective tube shell and the stone removing tube, so that the rotating stone removing tube is in direct contact with tissues of a patient, and iatrogenic injury is caused.
In an optional embodiment, the one end that the protective tube kept away from the arced tube is provided with the flexible pad, the flexible pad is well logical annular part, just the air vent has been seted up to flexible pad lateral wall, on the one hand can further avoid getting stone pipe and patient tissue direct contact through the flexible pad, on the other hand, through the air vent of flexible pad lateral wall, can avoid getting the intraductal negative pressure of stone and directly act on the gall bladder, and adsorb gall bladder tissue.
In an alternative embodiment, the inner diameter of the flexible pad is larger than the outer diameter of the stone removing tube, and the thickness of the flexible pad is smaller than 3mm, so that the influence of the flexible pad on stone suction of the stone removing tube is avoided.
In an alternative embodiment, a breathable stone blocking curtain is further arranged in the arc-shaped pipe, and the stone blocking curtain is positioned in one end of the arc-shaped pipe and one end of the stone taking pipe; the stone blocking curtain comprises a plurality of elastic bristles, the elastic bristles are uniformly distributed along the circumference of the arc-shaped pipe, and small stone scraps generated when stone breaking electrodes are blocked by the stone blocking curtain are prevented from splashing into the stone taking pipe under impact.
In an alternative embodiment, the method further comprises: the end, far away from the stone removing pipe, of the arc-shaped pipe is fixed on the handle; the broken stone transducer is arranged in the handle, and one end of the broken stone electrode penetrates through the arc-shaped pipe and is detachably connected with the broken stone transducer; one end of the fixed rod is fixedly connected with one end of the arc-shaped pipe, which is opposite to the stone taking pipe, and the other end of the fixed rod is fixedly connected with the top of the handle; the middle part of the lithotriptic electrode is provided with a sealing sleeve in a sealing manner, and the sealing sleeve can be slidably sealed and penetrated on the side wall of the arc-shaped pipe.
The stone extractor is convenient to hold by arranging the handle; the transducer is arranged in the handle, so that the influence of the vibration of the transducer on the stone taking tube can be reduced by hand; the broken stone electrode is detachably connected with the broken stone transducer, so that on one hand, the broken stone electrode and the broken stone transducer are convenient to install, and on the other hand, the broken stone transducer can be reused; one end of the fixing rod is fixedly connected with one end of the arc-shaped pipe, which is opposite to the stone taking pipe, and the other end of the fixing rod is fixedly connected with the top of the handle, so that the structural rigidity of the stone taking device can be provided, and the shake of the stone taking pipe is further reduced.
In an optional embodiment, still include the bellows, the bellows is installed the top of handle, the bellows with the arc pipe is kept away from the one end of getting the stone pipe links to each other, the bellows other end is used for connecting the negative pressure source to make and get stone implement and negative pressure source and be the flexonics directly, avoid connecting the pipeline to cause the influence to getting the stone operation, the bellows can not cause the influence to the flow of fluid when warping moreover, can ensure that the negative pressure source can be continuous provide the negative pressure for getting the stone implement.
Compared with the prior art, the application has the following advantages and beneficial effects:
1. the stone extractor for hepatobiliary surgery provided by the application is characterized in that a convex edge is spirally arranged in a stone extracting tube capable of rotating along the axis of the stone extracting tube, one end of the stone extracting tube is connected with one end of an arc-shaped tube, and the other end of the arc-shaped tube can be connected with a negative pressure source; before the stone taking operation, connecting the arc-shaped pipe with a negative pressure source so as to continuously provide negative pressure for the stone taking pipe, and connecting the stone breaking electrode with a corresponding driving module; during the stone extraction operation, one end of the stone extraction pipe is covered outside the stones, the stones are sucked through negative pressure and conveyed through the convex edges, so that the stones are conveyed into the arc-shaped pipe and blocked by the stone blocking plate, the stones are broken through the stone blocking electrode, and the negative pressure source is disconnected, so that the broken stones fall into the stone storage pipe under the action of gravity, and the stones are prevented from being blocked in the arc-shaped pipe to influence the suction of the next stones; and then, the next stone can be sucked only by communicating the negative pressure source again, so that the continuous taking out of multiple stones is realized, the stone taking efficiency is improved, and the stone taking operation time is shortened.
2. The stone extractor for hepatobiliary surgery provided by the application can be used for extracting stones with smaller particle size and small adhesive force, can be directly sucked into the stone extraction tube under the action of negative pressure, can be sent into the arc tube under the combined action of the negative pressure and the convex edges, and finally can be adsorbed on the stone baffle plate through the negative pressure, so that the stones with larger particle size or larger adhesive force can be extracted, and the stone extraction tube can be moved to enable the stones to be contacted with the convex edges in the stone extraction tube, so that the stones are unscrewed from the gall bladder wall through the relative rotation of the convex edges and the stones, and then can be sent into the arc tube under the combined action of the negative pressure and the convex edges, and finally can be adsorbed on the stone baffle plate through the negative pressure, thereby meeting the common stone extraction requirements of the stones, and being suitable for most of hepatobiliary surgery.
3. According to the stone extractor for hepatobiliary surgery, only the stone extraction pipe is required to be aligned with stones in the stone extraction process, the negative pressure source continuously provides negative pressure, and the convex edges keep a rotating state, so that stones entering the stone extraction pipe can be prevented from falling again. In the stone breaking process, the generated small-size stone breaking is stuck to the stone blocking plate under negative pressure suction, so that the risk of clamping and breaking the stone and falling the stone does not exist, the operation difficulty is low, the requirement on medical staff is low, and the physical and mental loss of the medical staff can be reduced.
4. The stone extractor for hepatobiliary surgery provided by the application only needs to insert the stone extraction tube into a patient in the whole stone extraction process, the stone extraction tube has no opening and closing structure, the volume is smaller, the stone extraction tube can not be expanded, compared with the stone extraction forceps or basket wires, the size of an incision in the abdomen of the patient can be reduced, and the operation is more minimally invasive.
Drawings
In order to more clearly illustrate the technical solutions of the embodiments of the present application, the drawings that are needed in the embodiments will be briefly described below, it being understood that the following drawings only illustrate some embodiments of the present application and therefore should not be considered as limiting the scope, and other related drawings may be obtained according to these drawings without inventive effort for a person skilled in the art.
In the drawings:
FIG. 1 is a schematic view of a stone extractor for hepatobiliary surgery according to an embodiment of the present application;
FIG. 2 is a schematic view of a stone removal tube according to an embodiment of the present application;
fig. 3 is an enlarged schematic view of a portion a of fig. 1.
In the drawings, the reference numerals and corresponding part names:
10-stone extraction tube, 11-convex rib, 20-arc tube, 21-straight tube section, 22-stone baffle plate, 23-stone baffle curtain, 30-Chu Danguan, 40-stone electrode, 41-sealing sleeve, 50-rotary driving assembly, 51-stator ring, 52-rotor ring, 60-protective tube shell, 61-flexible pad, 62-vent hole, 70-handle, 71-stone transducer, 80-fixed rod and 90-corrugated tube.
Detailed Description
For the purpose of making the objects, technical solutions and advantages of the embodiments of the present application more apparent, the technical solutions of the embodiments of the present application will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present application, and it is apparent that the described embodiments are some embodiments of the present application, but not all embodiments of the present application. The components of the embodiments of the present application generally described and illustrated in the figures herein may be arranged and designed in a wide variety of different configurations.
It should be noted that: like reference numerals and letters denote like items in the following figures, and thus once an item is defined in one figure, no further definition or explanation thereof is necessary in the following figures. Embodiments of the application and features of the embodiments may be combined with each other without conflict.
In the description of the embodiments of the present application, the terms "center", "upper", "lower", "left", "right", "vertical", "longitudinal", "lateral", "horizontal", "inner", "outer", "front", "rear", "top", "bottom", etc. indicate orientations or positional relationships based on those shown in the drawings, or those conventionally put in use of the product of the application, or those conventionally understood by those skilled in the art, are merely for convenience of description and simplicity of description, and do not indicate or imply that the apparatus or elements referred to must have a specific orientation, be configured and operated in a specific orientation, and therefore should not be construed as limiting the present application.
In the description of the present application, unless explicitly stated and limited otherwise, the terms "disposed," "mounted," "connected," "coupled," and "connected" 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.
Examples
With reference to fig. 1, this embodiment provides a stone extractor for hepatobiliary surgery, comprising: the stone removing pipe 10 can rotate along the axis of the stone removing pipe 10, at least one rib 11 is arranged on the inner wall of the stone removing pipe, and the rib 11 is spirally arranged along the axial direction of the stone removing pipe 10; an arc tube 20, one end of which is sleeved outside the stone removing tube 10, and the other end of which is used for connecting a negative pressure source; chu Danguan 30, which is communicated with the arc-shaped pipe 20, wherein the joint of the Chu Danguan and the arc-shaped pipe 20 is positioned at the vault section of the arc-shaped pipe 20 along the length direction of the connecting pipe, and the Chu Danguan is arranged at the same side of the stone removing pipe 10; a stone blocking plate 22, which is located in the arc-shaped pipe 20 and is adapted to the cross section of the arc-shaped pipe 20, wherein the stone blocking plate 22 can breathe, and the stone blocking plate 22 is located at the rear side of the stone storage pipe 30 along the length direction of the connecting pipe; a stone breaking electrode 40 penetrating the arc tube 20, wherein the working end of the stone breaking electrode 40 protrudes out of one side of the stone blocking plate 22 opposite to the stone storage tube 30; the rotary driving assembly 50 is in transmission connection with the stone removing pipe 10 and is used for driving the stone removing pipe 10 to rotate along the axis of the stone removing pipe; under the conditions that the stone removing tube 10 rotates and the arc tube 20 is connected with a negative pressure source, gall stones can be conveyed into the arc tube 20 along the axial direction of the stone removing tube 10 and blocked by the stone blocking plate 22, and stone particles broken by the stone breaking electrode 40 can fall into the stone storage tube 30.
Specifically, referring to fig. 2, at least one clamping groove is disposed in the stone removing tube 10, the clamping groove is spirally disposed along the axial direction of the stone removing tube 10, and the protruding rib 11 is clamped in the clamping groove. Generally, the draw-in groove adopts the mode of broach processing, directly processes out the helicla flute in getting stone pipe 10, after the helicla flute processing is accomplished, directly to bead 11 card in it can to be convenient for install bead 11 reliably in getting stone pipe 10 wall, and for welding, bonding, simple to operate is convenient. Optionally, the ribs 11 are generally made of flexible materials, so that the components are convenient to install, and collision with stones can be buffered, so that stones are prevented from being crashed in the process of conveying the stones.
It should be appreciated that the curved tube 20 has a straight tube section 21 at one end, and the stone removing tube 10 is rotatably inserted into the straight tube section 21, so as to reliably connect the curved tube 20 with the stone removing tube 10.
Further, a breathable stone curtain 23 is further arranged in the arc-shaped pipe 20, and the stone curtain 23 is positioned in one end of the arc-shaped pipe 20 and one end of the stone taking pipe 10; the stone blocking curtain 23 comprises a plurality of elastic bristles, the elastic bristles are uniformly distributed along the circumferential direction of the arc-shaped pipe 20, and small stone scraps generated when the stone breaking electrode 40 breaks stones are blocked by the stone blocking curtain 23, so that the stone scraps are prevented from splashing into the stone taking pipe 10 under impact.
Meanwhile, the method also comprises the following steps: a handle 70, wherein an end of the arc tube 20 away from the stone removing tube 10 is fixed on the handle 70; a lithotripsy transducer 71 mounted in the handle 70, one end of the lithotripsy electrode 40 being detachably connected to the lithotripsy transducer 71 through the arc tube 20; one end of the fixed rod 80 is fixedly connected with one end of the arc-shaped pipe 20, which is opposite to the stone removing pipe 10, and the other end of the fixed rod is fixedly connected with the top of the handle 70; the middle sealing sleeve 41 of the lithotripsy electrode 40 is provided with a sealing sleeve 41, and the sealing sleeve 41 can be slidably sealed and penetrated on the side wall of the arc-shaped tube 20.
By providing a handle 70, the stone extractor is convenient to hold; the transducer is arranged in the handle 70, so that the influence of the vibration of the transducer on the stone removing tube 10 can be reduced by hand holding; the broken stone electrode 40 is detachably connected with the broken stone transducer 71, so that on one hand, the broken stone electrode and the broken stone transducer 71 are convenient to install, and on the other hand, the broken stone transducer 71 can be reused; one end of the fixing rod 80 is fixedly connected with one end of the arc-shaped pipe 20, which is opposite to the stone removing pipe 10, and the other end of the fixing rod is fixedly connected with the top of the handle 70, so that the structural rigidity of the stone removing device can be provided, and the shaking of the stone removing pipe 10 is further reduced.
In addition, still include bellows 90, bellows 90 installs the top of handle 70, bellows 90 with arc pipe 20 is kept away from the one end of getting stone pipe 10 links to each other, the bellows 90 other end is used for connecting the negative pressure source to make and get stone implement and negative pressure source and be the flexonics directly, avoid connecting line to cause the influence to getting the stone operation, and bellows 90 when the deformation moreover can not cause the influence to the flow of fluid, can ensure that the negative pressure source can be continuous provide the negative pressure for getting the stone implement.
For the rotary driving assembly 50, the rotary driving assembly 50 may be a motor provided with a driving gear or a motor adapted with other driving structures, in this embodiment, the rotary driving assembly 50 includes a stator ring 51 and a rotor ring 52, the stator ring 51 is coaxially fixed outside the straight tube section 21, the rotor ring 52 is coaxially fixed outside the stone removing tube 10, and the stator ring 51 is coaxially sleeved outside the rotor ring 52 to form a direct driving motor through the stator ring 51 and the rotor ring 52, so that the stone removing tube 10 is directly driven to rotate, the structure is simple, transmission components are omitted, the rotation of the stone removing tube 10 is stable, and the weight of the stone removing device is small.
On this basis, still include the protective tube shell 60, protective tube shell 60 cover is established outside the stone extraction tube 10, protective tube shell 60 one end with stator ring 51 fixed connection, just protective tube shell 60 with be provided with the space between the stone extraction tube 10 to rotatory stone extraction tube 10 and patient's tissue direct contact cause the iatrogenic damage.
Wherein, be provided with two sealing rings on getting stone pipe 10 interval, two sealing rings are located the both sides of rotor ring 52 respectively, and on the one hand avoid gas to flow through from getting stone pipe 10 and the space between the protective tube shell 60, on the other hand can avoid the chip, flushing fluid to enter into between stator ring 51 and the rotor ring 52.
Referring to fig. 3, a flexible pad 61 is disposed at an end of the protective tube shell 60 away from the arc tube 20, the flexible pad 61 is a hollow annular part, and a vent hole 62 is formed in a side wall of the flexible pad 61, so that on one hand, the stone removing tube 10 can be further prevented from being in direct contact with a patient tissue by the flexible pad 61, and on the other hand, negative pressure in the stone removing tube 10 can be prevented from directly acting on the gall bladder to adsorb the gall bladder tissue by the vent hole 62 on the side wall of the flexible pad 61.
Specifically, the inner diameter of the flexible pad 61 is larger than the outer diameter of the stone removing tube 10, and the thickness of the flexible pad 61 is smaller than 3mm, so that the influence of the flexible pad 61 on the stone removing tube 10 (usually, stones smaller than 5mm can be directly sucked by negative pressure in operation) is avoided.
It should be noted that, because the size of the stone is large, stone extractors with various specifications can be manufactured, and when the stone extraction operation is performed, the corresponding stone extractor is generally selected according to the stone with the largest size. The size and position of the calculus can be directly determined by abdomen color Doppler ultrasound.
Before the stone extractor provided by the embodiment is used for carrying out stone extraction operation, the arc-shaped pipe 20 is connected with a negative pressure source (a switch valve is usually arranged between the negative pressure source and the arc-shaped pipe 20) so as to continuously provide negative pressure for the stone extractor 10, one end of the stone extractor 10 is covered outside stones during the stone extraction operation, the stones are sucked through the negative pressure and conveyed through the convex edges 11, so that the stones are conveyed into the arc-shaped pipe 20 and blocked by the stone blocking plate 22, the stones are crushed through the stone crushing electrode 40, the negative pressure source is disconnected, and the stone extractor 10 is in a vertical state and the corresponding stone storage pipe 30 is also in a vertical state during the stone extraction operation, so that the crushed stones fall into the stone storage pipe 30 under the action of gravity, and the stones are prevented from being blocked in the arc-shaped pipe 20 to influence the suction of the next stone; and then, the next stone can be sucked only by communicating the negative pressure source again, so that the continuous taking out of multiple stones is realized, the stone taking efficiency is improved, and the stone taking operation time is shortened. For the suction of the next stone, it is generally only necessary to change the angle of inclination interface of the stone removal tube 10.
Wherein, for stones with smaller grain size and small adhesive force, the stones can be directly sucked into the stone taking pipe 10 under the action of negative pressure, then sent into the arc-shaped pipe 20 under the combined action of the negative pressure and the convex edges 11, and finally adsorbed on the stone baffle plate 22 through the negative pressure. For stones with larger particles or larger adhesive force, the stone taking tube 10 can be moved to enable the stones to be in contact with the convex edges 11 in the stone taking tube 10, so that the stones are unscrewed from the gall bladder wall through the relative rotation of the convex edges 11 and the stones, then the stones are conveyed into the arc-shaped tube 20 by the stone taking tube 10 under the combined action of negative pressure and the convex edges 11, and finally are adsorbed on the stone baffle plate 22 through the negative pressure. Therefore, the utility model can meet the common calculus removing requirement, and is suitable for most liver and gall time removing surgical operations.
Meanwhile, in the stone extraction process, only the stone extraction tube 10 is required to be aligned with the stones, the negative pressure source continuously provides negative pressure, the convex edges 11 keep a rotating state, and stones entering the stone extraction tube 10 can be prevented from falling off again. In the stone breaking process, the generated small-size stone breaking is stuck to the stone blocking plate 22 under negative pressure suction, so that the stone cannot fall back, the risks of clamping and breaking the stone and falling the stone are avoided, the operation difficulty is low, the requirements on medical staff are low, and the physical and mental losses of the medical staff can be reduced.
In addition, in the whole stone extraction process, only the stone extraction tube 10 is required to be inserted into a patient, the stone extraction tube 10 has no opening and closing structure, the size is small, the size cannot be enlarged, and compared with the process of adopting a stone extraction clamp or a basket wire, the size of an incision in the abdomen of the patient can be reduced, and the operation is more minimally invasive.
In summary, the stone extractor for hepatobiliary surgery provided in this embodiment can continuously extract stones, reduce the difficulty of stone extraction, and avoid the gall stones from falling down in the stone extraction process, thereby reducing the operation burden of medical staff and relieving the pain of patients.
The foregoing description of the embodiments has been provided for the purpose of illustrating the general principles of the application, and is not meant to limit the scope of the application, but to limit the application to the particular embodiments, and any modifications, equivalents, improvements, etc. that fall within the spirit and principles of the application are intended to be included within the scope of the application.

Claims (10)

1. A stone extractor for hepatobiliary surgery, comprising:
the stone taking pipe (10) can rotate along the axis of the stone taking pipe, at least one convex rib (11) is arranged on the inner wall of the stone taking pipe, and the convex rib (11) is spirally arranged along the axial direction of the stone taking pipe (10);
an arc tube (20), one end of which is sleeved outside the stone taking tube (10), and the other end of which is used for connecting a negative pressure source;
chu Danguan (30) communicated with the arc-shaped pipe (20), wherein the joint of the Chu Danguan (30) and the arc-shaped pipe (20) is positioned on the vault section of the arc-shaped pipe (20) along the length direction of the stone extraction pipe (10), and the Chu Danguan (30) and the stone extraction pipe (10) are arranged on the same side;
the stone blocking plate (22) is positioned in the arc-shaped pipe (20) and is matched with the cross section of the arc-shaped pipe (20), the stone blocking plate (22) can breathe, and the stone blocking plate (22) is positioned at the rear side of the Chu Danguan (30) along the length direction of the stone taking pipe (10);
the stone breaking electrode (40) is arranged in the arc-shaped pipe (20) in a penetrating way, and the working end of the stone breaking electrode (40) protrudes out of one side of the stone blocking plate (22) opposite to the Chu Danguan (30);
the rotary driving assembly (50) is in transmission connection with the stone removing pipe (10) and is used for driving the stone removing pipe (10) to rotate along the axis of the stone removing pipe;
under the conditions that the stone taking pipe (10) rotates and the arc-shaped pipe (20) is connected with a negative pressure source, gall stones can be conveyed into the arc-shaped pipe (20) along the axial direction of the stone taking pipe (10) and blocked by the stone blocking plate (22), and stone particles crushed by the stone breaking electrode (40) can fall into the Chu Danguan (30).
2. The stone extractor for hepatobiliary surgery according to claim 1, wherein at least one clamping groove is arranged in the stone extractor tube (10), the clamping groove is spirally arranged along the axial direction of the stone extractor tube (10), and the convex rib (11) is clamped in the clamping groove.
3. The stone extractor for hepatobiliary surgery according to claim 1, wherein one end of said arc-shaped tube (20) is a straight tube section (21), said stone extractor tube (10) being rotatably inserted in said straight tube section (21).
4. A stone extractor for hepatobiliary surgery according to claim 3, wherein said rotary drive assembly (50) includes a stator ring (51) and a rotor ring (52), said stator ring (51) being coaxially fixed outside said straight tube section (21), said rotor ring (52) being coaxially fixed outside said stone extractor tube (10), said stator ring (51) being coaxially sleeved outside said rotor ring (52).
5. The stone extractor for hepatobiliary surgery according to claim 4, further comprising a protective tube shell (60), wherein the protective tube shell (60) is sleeved outside the stone extractor tube (10), one end of the protective tube shell (60) is fixedly connected with the stator ring (51), and a gap is provided between the protective tube shell (60) and the stone extractor tube (10).
6. The stone extractor for hepatobiliary surgery according to claim 5, wherein a flexible pad (61) is provided at the end of the protective tube shell (60) away from the arc tube (20), the flexible pad (61) is a hollow annular part, and a vent hole (62) is provided on the side wall of the flexible pad (61).
7. The stone extractor for hepatobiliary surgery according to claim 6, characterized in that the inner diameter of said flexible pad (61) is greater than the outer diameter of said stone extractor tube (10), the thickness of said flexible pad (61) being less than 3mm.
8. The stone extractor for hepatobiliary surgery according to claim 1, wherein said arc tube (20) is further provided with a breathable barrier Dan Lian (23), said barrier Dan Lian (23) being located in one end of said arc tube (20) and said stone extractor tube (10); the baffle Dan Lian (23) comprises a plurality of elastic bristles which are uniformly distributed along the circumference of the arc-shaped pipe (20).
9. The stone extractor for hepatobiliary surgery according to any one of claims 1 to 8, further comprising:
a handle (70), wherein one end of the arc-shaped pipe (20) far away from the stone removing pipe (10) is fixed on the handle (70);
a lithotripsy transducer (71) arranged in the handle (70), wherein one end of the lithotripsy electrode (40) passes through the arc-shaped pipe (20) to be detachably connected with the lithotripsy transducer (71);
one end of the fixed rod (80) is fixedly connected with one end of the arc-shaped pipe (20) which is opposite to the stone taking pipe (10), and the other end of the fixed rod is fixedly connected with the top of the handle (70);
the middle sealing sleeve (41) of the lithotripsy electrode (40) is provided with a sealing sleeve (41), and the sealing sleeve (41) can be slidably sealed and penetrated on the side wall of the arc-shaped tube (20).
10. The stone extractor for hepatobiliary surgery according to claim 9, further comprising a bellows (90), said bellows (90) being mounted on top of said handle (70), said bellows (90) being connected to an end of said curved tube (20) remote from said stone extractor (10), said bellows (90) being connected at the other end to a source of negative pressure.
CN202310182504.9A 2023-02-27 2023-02-27 Stone extractor for hepatobiliary surgery Active CN116269636B (en)

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