CN116982912A - Safe-placement medical endoscope device and ureteral lithotripsy operation system - Google Patents
Safe-placement medical endoscope device and ureteral lithotripsy operation system Download PDFInfo
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- CN116982912A CN116982912A CN202311162678.5A CN202311162678A CN116982912A CN 116982912 A CN116982912 A CN 116982912A CN 202311162678 A CN202311162678 A CN 202311162678A CN 116982912 A CN116982912 A CN 116982912A
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00064—Constructional details of the endoscope body
- A61B1/00071—Insertion part of the endoscope body
- A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
- A61B1/00082—Balloons
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
- A61B1/0125—Endoscope within endoscope
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
- A61B1/018—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
- A61B1/041—Capsule endoscopes for imaging
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements 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
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/01—Measuring temperature of body parts ; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/22—Ergometry; Measuring muscular strength or the force of a muscular blow
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M29/00—Dilators with or without means for introducing media, e.g. remedies
- A61M29/02—Dilators made of swellable material
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M31/00—Devices for introducing or retaining media, e.g. remedies, in cavities of the body
Abstract
The invention provides a safe-placement medical endoscope device and a ureteral lithotripsy operation system, which relate to the field of medical appliances, wherein the head of an endoscope main body is provided with an inflatable bag body structure, the inner surface area of a bag body free part is connected with a hollow bag body extension tube, and the bag body extension tube is provided with an inner opening of the bag body extension tube and an outer opening of the bag body extension tube; a fastening mechanism which can be tightly connected with the tail part of the endoscope body is arranged adjacent to the outer opening area of the sheath body, and the fastening mechanism is started to tightly connect the sheath body with the endoscope body, so that the synchronous advancing and retreating of the endoscope body and the sheath body are realized; the integrated head protection of the mirror sheath and the integrated synchronous placement of the mirror sheath eliminate complicated steps and improve the operation efficiency while fully guaranteeing the safety of the natural cavity of a patient.
Description
Technical Field
The invention relates to a safe-placement medical endoscope device and a transureteral lithotripsy operation system, belonging to the technical field of medical appliance products.
Background
The existing medical endoscope is divided into a hard endoscope with an elongated endoscope body which cannot or is not easy to bend, a soft endoscope with an easily-bent endoscope body, and a combined endoscope with the soft endoscope sleeved in the hard endoscope, wherein the hard endoscope has high strength and is easy to enter a natural cavity channel or a pathological sinus channel of a living body, and the soft endoscope has the defect of difficult implantation, but is more elongated and softer, can contact the natural cavity channel for a longer time in operation and has less damage; such as transurethral laser kidney stone surgery, is typically performed by: 1. the hard lens enters the bladder and ureter from the urethra; 2. a guidewire is then inserted through the working channel of the hard scope to the renal pelvis; 3. leaving the guide wire in the urinary tract only after the hard lens is withdrawn; 4. then the ureteral sheath tube and the sheath core positioned in the sheath tube are placed through the guide wire; 5. withdrawing the sheath core in the ureter sheath tube; 6. then the soft lens is inserted into the ureteral sheath tube, and the working channel which is opened at the head part of the soft lens bears the functions of optical fiber lithotripsy, cooling and flushing, stone extraction and the like; the soft lens is placed in the device in a plurality of steps, and the operation is complicated; and no matter the hard mirror and the soft mirror, when the endoscope assembly is pushed in the natural cavity of a living body, the hard edge part of the head of the endoscope assembly is continuously and dynamically contacted with the mucosa of the natural cavity, the shearing damage is difficult to avoid, and the shearing damage is more serious when encountering the narrow part of the natural cavity, even the perforation of the natural cavity occurs; the safety protection measures in the prior art are weak or even have no safety protection measures, and the natural cavity mucosa is easy to secondarily infect and cause dysfunction after shearing damage.
The invention provides a safe-placement medical endoscope device and a ureteral lithotripsy operation system, wherein the head of the endoscope is provided with an inflatable bag body structure, the head of the endoscope is protected by an integral head of the endoscope sheath, and the endoscope and the sheath are synchronously placed in the integral head of the endoscope; the soft capsule shielding part is used for avoiding shearing damage to a soft mucosa of a natural cavity tract on the whole range of the head edge of a hard sheath tube main body, when the device is pushed in the natural cavity tract to meet resistance, fluid is filled into the inner cavity of the inflatable capsule body from outside to expand the radial flexible expansion natural cavity tract, the filling is relieved to restore the capsule body, the expanded natural cavity tract is not restored to a state at the moment, the resistance is minimum when the device is pushed continuously, and the value is particularly outstanding when the natural cavity tract is met to be narrow; the invention eliminates complicated steps and improves the operation efficiency while fully guaranteeing the safety of the natural cavity of the living body.
Disclosure of Invention
The purpose of the invention is realized in the following way:
a safe imbedding medical endoscope device, an optical component is arranged on a slender endoscope main body, the endoscope main body is provided with a working channel penetrating through the head and the tail, and the working channel is provided with a working channel inner opening which enters the body when in use and a working channel outer opening which is positioned outside the body when in use; the long and thin sheath tube main body is sleeved outside the endoscope main body, the sheath tube main body is provided with a sheath tube main body inner opening which enters the body when in use and a sheath tube main body outer opening which is positioned outside the body when in use, the top end of the head of the endoscope main body is coated with an expandable bag body, the bag body consists of a bag body connecting part and a bag body free part, the bag body connecting part is connected with the outer surface of the head of the endoscope main body in a cylinder shape, the bag body free part is an expandable bag body part, and a gap between the bag body free part and the top end of the head of the endoscope main body forms a bag body inner cavity; the maximum outer diameter of the free part of the inflated capsule body is at least larger than the outer diameter of the head of the endoscope main body; the free portion of the balloon is transparent or at least the region corresponding to the optical element at the distal end of the head of the endoscope body is transparent.
The more outstanding structure is that the inner surface area of the free part of the capsule body is connected with a hollow capsule body extension tube, and the capsule body extension tube is provided with an inner opening of the capsule body extension tube positioned on the free part of the capsule body and an outer opening of the capsule body extension tube positioned outside the body when in use; the capsule extension tube can directly penetrate into the endoscope working channel or with the assistance of a guide wire, and the tail end of the capsule extension tube penetrates out of the outer opening of the endoscope working channel; external fluid can enter the inner cavity of the capsule body through a filling gap between the outer surface of the capsule body extension tube and the inner surface of the working channel so as to expand the free part of the capsule body.
When the endoscope is used, the top end of the head of the endoscope main body protrudes out of the inner opening of the sheath main body, at least a part of the free part of the capsule body is exposed, and the fastening mechanism is started to enable the sheath main body to be tightly connected with the endoscope main body, so that synchronous advancing and retreating of the endoscope main body and the sheath main body in a combined mode can be realized; when the endoscope main body moves forward in the natural cavity of the living body and is blocked, fluid can be filled into the inner cavity of the capsule body through the filling gap to expand the free part of the capsule body, so that the tissue at the narrow part of the natural cavity is radially and flexibly expanded, and the endoscope main body can move forward in the expanded natural cavity conveniently; after the device reaches the target position, the fastening mechanism is loosened, the combined state of the endoscope and the sheath is released, and the endoscope main body can freely rotate or move back and forth in the inner cavity of the sheath main body.
The inner cavity of the bag body extension tube can be used for the guide wire to pass through, so that a guide wire imbedding passage and the assistance of advancing along the guide wire are formed; the medicine can be injected into natural cavity and pathology Dou Daona through the inner cavity of the capsule body extension tube, including lubricating, diagnostic and therapeutic medicines; also expandable, diagnostic, therapeutic gases may be injected; the balloon extension tube moves in the endoscope working channel, can pull the balloon free part in the expanded state, promotes the resetting, controls the expansion degree and adjusts the shape of the balloon free part in the expanded state, thereby meeting the individual operation requirements of patients or doctors; on the premise that the balloon extension tube exists, external fluid filled in the free part of the balloon is injected into the inner cavity of the balloon through a perfusion gap between the outer surface of the balloon extension tube and the inner surface of the working channel of the endoscope.
The guide wire is penetrated into the capsule extension tube, so that the medical endoscope can be led by the guide wire to advance with the sheath tube or can be expanded along the guide wire to expand a longer natural cavity when the free part of the capsule is filled; in order to avoid the influence of the free part of the capsule body on the forward expansion of the natural cavity channel along the guide wire, the inner cavity of the extension tube of the capsule body and the opening area in the extension tube of the capsule body are preferably in non-interference contact with the guide wire penetrating into the extension tube of the capsule body; the periphery of the inner opening of the capsule extension tube is provided with a reinforcing structure, the reinforcing structure comprises an annular thick-wall reinforcing rib surrounding the inner opening of the capsule extension tube and a hollow upper thickening section and a hollow lower thickening section which are connected with the inner opening of the capsule extension tube into a whole, a guide wire penetrates through the thickening sections, the free part of the capsule can not be held tightly by the free part possibly adduced in the inner opening area of the capsule extension tube when the free part of the capsule is expanded, and the free part of the capsule can be ensured to expand along the guide wire when the free part of the capsule is filled.
The capsule body is preferably made of a compliant material and can extend forwards while flexibly and radially expanding the natural cavity; the bag body connecting part is in a cylinder shape and is connected with the outer surface of the head of the endoscope main body in an easily-separated mode, the bag body is taken down to expose the working channel after the expansion task is completed, and other subsequent medical operations are carried out through the working channel.
The fastening mechanism can be arranged at the tail part of the endoscope main body, can be preferably arranged at the tail part of the sheath main body, can be an independent component and is connected with the tail part of the endoscope main body and the tail part of the sheath main body when in use; the fastening mechanism not only can enable the endoscope sheath to integrally move, but also ensures the stability of the relative positions of the capsule body, the endoscope and the sheath tube.
The medical endoscope in the present invention covers a soft scope in which the endoscope body is bendable and a hard scope in which the endoscope body is not bendable, and covers an electronic scope and an optical scope.
Preferably, a conical protrusion protruding to the distal end is arranged on the free part of the capsule body at the periphery of the inner opening of the capsule body extension tube; the flexible conical protrusions are beneficial to the pushing of the endoscope in the natural cavity, the conical protrusions are pushed to further advance after the balloon body is expanded, the more front natural cavity is expanded synchronously, and the effect of extension expansion is achieved.
For ease of handling, a section of the endoscope body adjacent the opening in the working channel is a sheath bendable section and/or a section of the endoscope body adjacent the opening in the sheath body is an endoscope bendable section; the bendable section makes the endoscope difficult to have vision and operation dead angles in the renal pelvis and the renal calyx.
The scheme for increasing the volume of the inflated bag body is that a hollow nipple-shaped protrusion is arranged at the periphery of an inner opening of a bag body extension tube on the free part of the bag body, and/or one or more annular wrinkles are arranged on the free part of the bag body; the nipple facilitates extended inflation of the balloon free portion after filling; the annular wrinkles can enable the surface area of the free part of the capsule body to be obviously increased on the premise of unchanged plane projection area of the top end of the head of the endoscope main body, so that the volume of the cavity of the capsule body after expansion is increased, and the expansion along the axial extension of the natural cavity channel during filling is facilitated, and the longer natural cavity channel is expanded.
In order to ensure that the balloon can be stably inflated and inflated for a plurality of times, the wall thickness and/or the strength of the balloon connecting part of the balloon are larger than those of the balloon free part; the connection part of the balloon is prevented from being pulled to separate from the head of the endoscope main body when the free part of the balloon is inflated.
In order to protect the natural luminal mucosa from the sharp edges at the inner opening of the sheath body, a flexible balloon shielding part which can shield or cover the outer edge of the inner opening of the sheath body is extended outwards at the junction of the free part of the balloon and the connecting part of the balloon.
Further, a cylindrical flanging is arranged at the shielding part of the flexible bag body, which extends outwards from the junction of the free part of the bag body and the connecting part of the bag body, and fully covers the outer edge of the inner opening of the sheath tube; the inner opening outer edge of the thin-walled sheath tube is sharp, the inner cavity membrane contacted by the shearing damage is easy to cut when the sheath tube moves forwards, the flexible bag body shielding part fully covers the inner opening outer edge of the sheath tube, the risk of the shearing damage is eliminated, and the dual protection effect on the mucous membrane of the natural cavity is achieved by combining the characteristic that the free part of the bag body moves forwards in an expanding mode.
In order to facilitate the operation of operators, a hollow elastic power bag is connected with the outer opening of the working channel, and the elastic power bag is extruded to fill the fluid in the elastic power bag into the inner cavity of the bag body so as to expand the free part of the bag body; releasing the fluid in the inner cavity of the extruded bag body from flowing back to the inner cavity of the elastic power bag; typically, a gas in the lumen of the elastic power bladder is used.
The ureteral lithotripsy operation system comprises at least one of a perfusion device, a lithotripsy optical fiber, a negative pressure suction device, a pressure sensor, a temperature sensor, a calculus basket and a guide wire besides the safe imbedding type medical endoscope device.
The pressure sensor and the temperature sensor can be arranged at the position adjacent to the opening in the sheath tube main body, and can also be arranged at the head of the endoscope main body, so that the pressure and the temperature in the urinary tract can be conveniently monitored during operation, and the operation safety is ensured; in order to reduce friction with natural lumen mucosa and parts, at least one or more of the outer surface of the free part of the capsule body, the outer surface of the endoscope body, the inner surface of the sheath body, the outer surface of the extension tube of the capsule body and the inner surface of the working channel of the endoscope are provided with hydrophilic coatings.
The beneficial effects of the invention are as follows:
1. in the natural cavity channel propelling process of the endoscope, the hard head edge of the sheath tube main body is protected by the shielding part of the flexible bag body in the whole process, so that the mucous membrane shearing damage in the endoscope placing process is obviously reduced.
2. When the endoscope is placed in a natural cavity stenosis, the balloon of the head of the endoscope body is inflated, and after the tissue at the stenosis is radially expanded, the balloon is relieved, so that the subsequent passing is facilitated.
3. The fastening mechanism enables the endoscope and the sheath tube to be synchronously propelled, so that the operation steps are reduced, and the efficiency is improved.
4. The head capsule body on the basis of visualization expands and moves forward, so that the use of a guide wire in the mirror placing process can be omitted.
5. The head capsule body under the pressure monitoring expands and expands the natural cavity, and the expansion effect is safer and more reliable.
6. When the endoscope is placed into the urethra, the head capsule body of the endoscope main body can slowly and radially expand the urethral membrane part, so that the external urethral sphincter is protected, and the occurrence of postoperative urine control disorder is avoided to the greatest extent.
7. The junction of the flexible expansion ureter and the bladder protects the valsalva sheath, and the occurrence of postoperative vesicoureter reflux is avoided to the greatest extent.
8. In the process of pushing the endoscope device along the natural cavity, medicines or developers such as lubrication, smooth muscle relaxation and the like can be injected into the natural cavity through the inner cavity of the capsule body extension tube, so that the operation safety is ensured.
The invention remarkably simplifies the operation steps of the operation, reduces the tissue injury, greatly saves the operation time and reduces the treatment cost.
Drawings
The drawings that do not limit the invention are as follows:
fig. 1A: a sheath tube, a sheath core and a guide wire in the prior art are schematically used;
wherein, 1A-1: the sheath tube, the sheath core and the guide wire are combined together; 1A-2: a rigid endoscope is shown deployed within the guidewire G to the renal pelvis P; 1A-3: the sheath core is arranged in the sheath tube main body and moves upwards along the guide wire G;
fig. 1B: a schematic view of a prior art endoscope body 1 entering a sheath body 3;
wherein, 1B-1: the endoscope body 1 enters the sheath body 3, and the bendable head portion 12 of the endoscope body protrudes from the inner opening 321 of the sheath body; 1B-2: the sheath body head 32 is located proximal to the ureter U renal pelvis P junction; 1B-3: the bendable head 12 of the endoscope body partially protrudes through the opening in the sheath body and into the renal pelvis P;
fig. 1C: embodiment 1 an endoscope is schematically shown, the head 12 of the endoscope body is covered with an inflatable balloon 2, a balloon free portion 22 is connected with a balloon extension tube 24, the balloon extension tube 24 protrudes from an outer opening 112 of the working channel of the endoscope, an outer opening 242 of the balloon extension tube can be inserted into a blocking body 243, and the balloon blocking portion 23 is provided with a cylindrical flange 232;
fig. 1D: example 1 sheath body 3 schematic diagram, cross-section showing the fastening mechanism T of sheath tail 34;
fig. 1E: example 1 an endoscope body 1 and a sheath body 3 are combined in schematic view, and a fastening mechanism T of an elastic power bag 5 connected with a bag body 2 of the head of the endoscope body and a sheath tail 34 connected with an endoscope handle 15 are partially cut away;
fig. 1F: embodiment 1a schematic view of the separation state of two clasping arms T1 and a fastening knob T2 of a sheath body tail fastening mechanism T, in which an endoscope body tail 14 is placed;
fig. 1G: example 1a perspective view of an elastic power balloon 5 attached to an endoscope handle 15;
fig. 1H: a section view of the free portion 22 of the capsule covered by the head 12 of the endoscope body in an unexpanded state, the capsule extension tube 24 being positioned in the working channel 11, encountering the stenosis N of the ureter U;
fig. 1I: example 1 schematic cross-sectional view of the balloon free portion 22 in an inflated state, the ureter U stenoses N in the upper view being radially expanded;
fig. 1J: example 1a schematic cross-sectional view of the balloon free portion 22 in an inflated state, the balloon extension lumen 240 penetrating the guide wire G, the balloon free portion 22 being inflated under the guidance of the guide wire G;
fig. 1K: example 1 after the endoscope and sheath were integrally advanced to the junction of ureter U and renal pelvis P, the partial cross-section shows the separation of clasping arm T1 and tightening knob T2, with endoscope body head 12 penetrating from sheath body head 32 into renal pelvis P;
fig. 1L: example 1 the endoscope body was withdrawn from the sheath body lumen 31 to the outside, and the partial cross section shows the reverse deformation state of the shielding portion 23 of the balloon free portion;
fig. 2A: a cross-sectional view of the distally presented nipple-like extending tapered protrusion 228 in the region of the opening 241 in the balloon extension 24 of example 2;
fig. 2B: a schematic cross-sectional view of the balloon extension lumen 240 of example 2 penetrating the guidewire G;
fig. 3A: example 3 schematic illustration of annular corrugations 227 on balloon free portion 22, annular thick-walled ribs 223 in the region of opening 241 in balloon extension 24, downwardly thickened section 225;
fig. 3B: a schematic partial cross-sectional view of the balloon extension lumen 240 of example 3 penetrating guidewire G;
fig. 4A: schematic illustration of the upward thickening 224 of the peripheral region of the opening 241 in the balloon extension of example 4;
fig. 4B: a schematic partial cross-sectional view of the balloon extension lumen 240 of example 4 penetrating guidewire G;
fig. 5A: a schematic cross-sectional view of a distally projecting nipple 226 hollow in the peripheral region of opening 241 in balloon extension tube 24 of example 5;
fig. 5B: the balloon extension lumen 240 of example 5 is shown in cross-section penetrating a guidewire G, which is not cut.
Detailed Description
The embodiments of the present invention are not limited as follows:
example 1:
as shown in fig. 1C, a medical endoscope apparatus for safe placement, a bendable slender endoscope body 1 comprises an endoscope body head 12, an endoscope body middle 13 and an endoscope body tail 14, the endoscope body 1 is provided with a main channel 11 penetrating the head and the tail, the main channel 11 is provided with a main channel inner opening 111 which enters the body when in use and a main channel outer opening 112 which is positioned outside the body when in use, the endoscope body tail 14 is connected with an operation handle 15 for the user to operate the endoscope, and the operation handle 15 is provided with a power interface 151; the head top 121 of the endoscope main body 1 is coated with an expandable balloon 2, the balloon consists of a balloon connecting part 21 and a balloon free part 22, the balloon connecting part 21 is connected with the outer surface of the head 12 of the endoscope main body in a cylinder shape, the balloon free part 22 is an expandable part of the balloon 2, and a gap between the balloon free part 22 and the head top 121 of the endoscope main body 1 forms a balloon inner cavity 20; the maximum outer diameter of the inflated balloon free portion 22 is at least greater than the outer diameter of the distal end region of the endoscope body head 12; the balloon free portion 22 is transparent or at least the region corresponding to the optical component (as in fig. 1I) of the head tip 121 of the endoscope main body 1 is transparent; the inner cavity 20 of the bag body is communicated with the working channel 11; the inner side of the free portion 22 of the balloon body is connected with a hollow balloon body extension tube 24, most of the balloon body extension tube 24 is positioned in the working channel 11, the inner cavity 240 of the balloon body extension tube is provided with two openings, namely an inner opening 241 of the balloon body extension tube and an inner opening 242 of the balloon body extension tube, in this example, the proximal end portion of the balloon body extension tube 24 extends out of the outer opening 112 of the endoscope working channel on the handle extension section 152, and the outer opening 242 of the balloon body extension tube can be blocked by a blocking body 243.
As shown in fig. 1D, a sheath (herein, "sheath" and "sheath body" are described equally) matched with an endoscope, when in use, an elongated sheath body 3 is sleeved outside the endoscope body 1, the sheath body 3 comprises a sheath body head 32, a sheath body middle part 33 and a sheath body tail 34, the sheath body is provided with a sheath body inner opening 311 which enters the body when in use and a sheath body outer opening 312 and a sheath body side branch opening 313 which are positioned outside the body when in use, an adjusting button 341 is arranged on the sheath body side branch, and when the sheath body side branch opening is connected with a negative pressure suction device (not shown), the adjusting button 341 is used for adjusting whether the sheath side branch inner cavity 340 is communicated with the outside; the outer opening 312 of the sheath tube main body is provided with a fastening mechanism T which can be tightly connected with the tail 14 of the endoscope main body, in the embodiment, the fastening mechanism T consists of an arc-shaped lamellar cohesion arm T1 and a hollow fastening knob T2, the fastening knob T2 is provided with a round knob outer opening T22, the number of the cohesion arm T1 is two, the cohesion arm T1 is connected with the tail 34 of the sheath tube main body through a base T12 on the fastening mechanism T1, after the internal thread T21 of the fastening knob T2 is matched with the external thread T11 of the cohesion arm, the two cohesion arms T1 move radially towards the axis L, and the part (as shown in figure 1E) of the tail 14 of the endoscope main body positioned in the cohesion arm is clamped so that a scope sheath (the scope sheath refers to an endoscope and the sheath tube) can be synchronously propelled; fig. 1F shows that the two clasping arms T1 are separated from the tightening knob T2, and the clasping arms T1 are released from the grip on the endoscope body tail 14 portion, in which case the sheath is no longer tightly coupled and the endoscope body 1 is free to move back and forth and rotate within the sheath body 3.
As shown in fig. 1E and 1G, a hollow elastic power bag 5 is connected to the outer opening 112 of the working channel on the endoscope handle, the elastic power bag 5 is sleeved with the handle extension section 152 (see fig. 1C) through the extension part 51, so that the outer opening 112 of the endoscope working channel is communicated with the inner cavity 50 of the elastic power bag, the proximal end part of the bag extension tube 24 protrudes out of the outer opening 112 of the endoscope working channel and is positioned in the inner cavity 50 of the elastic power bag, when in use, the blocking body 243 is inserted into the outer opening 242 of the bag extension tube to block the outer opening, the inner cavity 50 of the elastic power bag can be filled with gas or liquid, and the inner cavity 50 of the elastic power bag is provided with a communication hole 52 (not shown) communicated with an external space; when the endoscope sheath of the invention is pushed in the ureter U, when encountering difficult advancing of the stenosis N (as shown in figure 1H), the elastic power bag 5 is extruded outside the body to fill the fluid (air in the example) in the elastic power bag into the inner cavity 20 of the bag body through the filling gap 110, wherein the filling gap 110 is the gap between the outer surface of the bag body extension tube 24 and the inner surface of the endoscope working channel 11, as shown in figure 1I, the fluid enters the inner cavity 20 of the bag body to expand the bag body free part 22, the stenosis N of the ureter U is subjected to flexible radial expansion, and the obstruction of the advancing of the stenosis N is eliminated on the premise of not shearing and damaging mucous membrane, so that the passage of the endoscope is facilitated; after the extrusion is released, the fluid in the inner cavity 20 of the bag body flows back to the inner cavity 50 of the elastic power bag, and the shape of the free part 22 of the bag body is restored to the shape before the expansion; the elastic power bag 5 can be repeatedly squeezed or relaxed by fingers, the bag body free part 22 is inflated or restored synchronously, the restoring capability of the elastic power bag 5 is fully utilized, and the use is convenient; the communication hole 52 on the elastic power bag 5 is particularly suitable for gas circulation, when in extrusion, a finger presses and seals the communication hole 52, the gas in the elastic power bag 5 fills into the bag body inner cavity 20, the finger is relaxed after the bag body free part 22 is expanded for a certain time, and the restoring of the elastic power bag 5 is added with the rapid outflow of the gas from the communication hole 52, so that the bag body free part 22 is restored more quickly; of course, the elastic power bag 5 can also be controlled by an external syringe or other electronically controlled perfusion devices and negative pressure suction devices.
When the device of the present invention is used before the natural orifice is expanded, if the device is to be performed under the guidance of the guide wire G, the guide wire G may be inserted through the inner lumen 240 of the balloon extension tube, and fig. 1J shows that the guide wire G is passed out from the opening 241 in the balloon extension tube, and the balloon free portion 22 is in a inflated state, in which case the balloon free portion 22 is inflated along the guide wire G, so as to expand the natural orifice better.
The inner cavity 240 of the balloon extension tube not only can be penetrated by the guide wire G, but also can be used as a passage for placing the guide wire G and a guide for advancing along the guide wire G; after the plugging body 243 is pulled out from the outer opening 242 of the capsule extension tube, medicines including lubricating, diagnostic and therapeutic medicines such as smooth muscle relaxant and developer can be injected into the natural cavity through the inner cavity 240 of the capsule extension tube; also expandable, diagnostic, therapeutic gases may be injected; the balloon extension tube 24 moves in the endoscope working channel 11, and can pull the balloon free part 22 in the expanded state, so as to promote the restoration, control the expansion degree and adjust the shape of the balloon free part 22 in the expanded state, thereby meeting the individual operation requirements of patients or doctors.
As shown in fig. 1I, one lens 10, two optical windows 101 are located at the head tip 121 of the endoscope body 1; the pressure sensor and the temperature sensor 102 can monitor the pressure of the balloon body free part 22 when expanding, thereby adjusting the radial expansion force, effectively expanding a narrow natural cavity and simultaneously ensuring the operation safety, and the temperature sensor can monitor the temperature change in the lithotripter process so as to avoid high-temperature damage.
Because the inner opening outer edge 322 (fig. 1A-1) of the thin-walled sheath body 3 is relatively sharp, when the sheath is advanced, the mucous membrane in the natural cavity contacted by the inner opening outer edge is easily sheared and damaged, in order to protect the mucous membrane in the natural cavity, the juncture of the free part 22 of the capsule and the connecting part 21 of the capsule extends outwards to form a flexible capsule shielding part 23 which can shield or cover the inner opening outer edge 322 of the sheath body 3, the horizontal wings 231 of the flexible capsule shielding part 23 are connected with cylindrical flanges 232, the cylindrical flanges 232 cover the inner opening outer edge 322 of the sheath more thoroughly, fig. 1E shows that the flexible shielding part 23 shields the inner opening outer edge 322 of the sheath body 3, the upper opening of the endoscope sheath gap 130 is blocked, and the mucous membrane of the ureter U cannot be sheared and damaged when the sheath is advanced in the ureter U; the dual protection effect is achieved by combining the characteristic that the free part 22 of the bag body can move forward in an expanding mode.
When the endoscope is used, the top end 121 of the head of the endoscope main body 1 moderately protrudes out of the inner opening 311 of the sheath main body, at least the free part 22 of the capsule body is exposed, and the fastening mechanism T is started to tightly connect the sheath main body 3 and the endoscope main body 1, so that the synchronous advancing and retreating of the combination of the sheath and the endoscope can be realized; when the endoscope main body 1 moves forwards in the natural cavity of the living body and is blocked, fluid can be filled into the inner cavity 20 of the capsule body through the filling gap 110 to expand the inner cavity, and the narrow part of the cavity is radially and flexibly expanded, so that the endoscope main body 1 can move forwards later; after the sheath body 3 reaches the target position, the fastening mechanism T is released, and the endoscope body 1 can freely rotate or move forward and backward in the sheath body 3.
As shown in fig. 1K, after the endoscope sheath of the device is integrally pushed to the target position, the fastening knob T2 is rotated in vitro to separate the clasping arm T1 from the fastening knob T2, the clamp of the clasping arm T1 to the tail 14 of the endoscope body is released, and the head 12 of the endoscope body protrudes from the opening 311 in the sheath body into the renal pelvis P; as shown in fig. 1L, the endoscope body 1 is withdrawn from the sheath body lumen 31, and the balloon free portion shielding portion 23 is deformed and tilted upward in the sheath gap 130; after the endoscope body head 12 is withdrawn from the sheath outer opening 312, the balloon 2 covering the endoscope body head 12 is withdrawn together with the balloon extension tube 24 through the upper opening 111 or the lower opening 112 of the working channel 11, the working channel 11 is exposed, and the endoscope body 1 is then placed into the sheath body lumen 31 for subsequent lithotripsy or other medical procedures (not shown).
The connection of the balloon connection portion 21 to the outer surface of the endoscope body head 12 in a tubular shape is an easily separable connection, and further medical operations are performed subsequently in order to expose the working channel.
The positions of the various tube bodies described in the invention describe that the head faces the far end part, and the tube bodies enter the body when in use; the tail part faces the proximal end part and is usually positioned outside the body when in use; the inner opening is a distal opening, and is positioned in the body when in use; the outer opening is a proximal opening, and is positioned outside the body when in use; "forward" is in the distal direction and "backward" is in the proximal direction; "upper", "front" are distally directed; "lower", "rear" are proximally directed.
The balloon 2 is preferably made of a compliant material that can be extended forward while flexibly radially expanding the natural orifice.
As shown in fig. 1A and 1B, in the endoscope system of the prior art, the hollow sheath body 3 includes a sheath body head 32, a sheath body middle 33 and a sheath body tail 34, the sheath has a sheath body inner opening 311 which enters the body in use and a sheath body outer opening 312 and a sheath body side branch opening 313 which are positioned outside the body, an adjusting button 341 is arranged on the sheath body side branch, and when the sheath body side branch opening 313 is connected with a negative pressure suction device (not shown), the adjusting button 341 is used for adjusting and controlling whether the sheath side branch inner cavity 340 is communicated with the outside, and a hollow elastic sealing plug S is arranged in the sheath body outer opening 312; the sheath core 4 comprises a sheath core head 42, a sheath core middle part 43 and a sheath core tail part 44, the sheath core inner cavity 41 is provided with a sheath core inner opening 411 and a sheath core outer opening 412, the sheath core outer opening 412 extends out of the sheath pipe main body tail part 34, the tail end of the sheath core tail part 44 is positioned outside the sheath pipe main body inner cavity 31, the tail end of the sheath core tail part 44 is provided with a clamping body 441, the clamping body 441 is in clamping connection with a bearing body 342 at the tail end of the sheath pipe main body tail part 34, after the clamping connection, a sheath pipe and the sheath core can synchronously advance and retreat, the sheath core head 42 extends out of the sheath pipe main body inner opening 311 in a tapered manner, the top end 321 of the sheath pipe main body 3 and the sharp inner opening edge 322 are visible in the drawing, and the guide wire G extends out of the sheath core inner opening 411 through the sheath core inner cavity 41.
The steps of the ureteral kidney stone operation mirror setting in the prior art are as follows: 1. 1A-2, the rigid endoscope head 12 enters the bladder from the urethra and then enters the ureter U;2. placing a guidewire G into the renal pelvis P along the rigid endoscope working channel; 3. leaving the guide wire in the urinary tract only after the hard lens is withdrawn; 4. 1A-3, a ureteral sheath and a sheath core therein are placed through a guide wire; 5. withdrawing a sheath core (not shown) in the ureter guiding sheath; 6. 1B-1, the flexible endoscope is then inserted from the ureteral sheath body lumen 31, with 1B-2 showing the sheath body head 32 positioned proximal to the ureteral U-renal pelvis P junction and the sheath body interior opening 311 facing the renal pelvis P;1B-3 shows the endoscope body head 12 partially protruding through the intrathecal opening 311 into the renal pelvis P; the working channel 11 which is opened on the head of the soft endoscope has the functions of light ray lithotripsy, cooling flushing, calculus extracting and the like, and the soft endoscope under the prior art has complicated operation process and no safety protection.
In the natural cavity channel propulsion process, the protective endoscope device provided by the invention has the advantages that the hard head edge of the sheath tube main body is protected by the flexible shielding part in the whole process, so that the mucous membrane shearing damage in the endoscope placement process is obviously reduced; when the endoscope is placed in a natural cavity stenosis, the balloon of the head of the endoscope main body is inflated, and the balloon is released after the stenosis is radially expanded, so that the subsequent passing is facilitated; the mirror sheath is synchronously pushed in, so that the operation steps are reduced, the efficiency is improved, the sheath core 4 part is omitted, and the use of a guide wire G can be omitted; head capsule expansion type advancing on the basis of visualization; the natural cavity is expanded after the head bag body under pressure monitoring is expanded, so that the expansion effect is more reliable; when the urethral catheter is placed in the urethra, the urethral membrane part can be slowly and radially expanded by the head capsule body, so that the external urethral sphincter is protected, and the occurrence of postoperative urine control disorder is avoided to the greatest extent; the joint of the flexible expansion ureter and the bladder protects the valsalva sheath, and avoids the occurrence of vesicoureter reflux after operation to the greatest extent; remarkably simplifying operation steps, reducing tissue injury, greatly saving operation time and reducing treatment cost.
Example 2:
in this example, as shown in fig. 2A, a tapered protrusion 228 extending to the distal end is provided on the free portion 22 of the balloon at the periphery of the opening 241 in the balloon extension tube, and the flexible tapered protrusion helps the endoscope to advance in the lumen, so that the tapered protrusion 228 is pushed forward after the balloon 2 is inflated, and the lumen in front is synchronously expanded, thereby achieving the effect of extension expansion.
As shown in fig. 2B, the guide wire G passes through the balloon extension lumen 240 and the tapered protrusion 228 thereon, and the balloon free portion 22 can be inflated under the guidance of the guide wire G to better dilate the natural orifice, especially the narrow natural orifice.
Example 3:
as shown in fig. 3A, the difference between the present embodiment and embodiment 2 is that, in order to strengthen the cooperation between the balloon 2 and the guide wire G, that is, to avoid the inner opening 241 of the balloon extension tube from being extruded and retracted to hug the guide wire G when the balloon free portion 22 is inflated, the inflated free portion 22 cannot extend along the guide wire, and the inner opening 241 of the balloon extension tube is provided with an annular thick-wall reinforcing rib 223 and a downward thickening section 225, so that the balloon free portion 22 does not hug the guide wire G when inflated.
In order to increase the volume after inflation under the same filling pressure, the balloon free portion 22 is provided with a plurality of annular folds 227 of increasing area; FIG. 3B shows the balloon extension tube lumen 240 penetrating the guidewire G; the annular folds 227 on the balloon free portion 22 enable the surface area of the balloon free portion 22 to be remarkably increased on the premise that the projection area of the head top 121 of the endoscope is unchanged, so that the volume of the inflated balloon inner cavity is increased, the balloon free portion 22 can extend and expand axially along a natural cavity when being inflated, and a longer narrow cavity can be inflated and expanded once.
Example 4:
as shown in fig. 4A and 4B, the difference from embodiment 3 is that the peripheral region of the opening 241 in the balloon extension tube is provided with an upward thickening 224, so as to avoid the balloon free portion 22 from clasping the guide wire G when expanding.
Example 5:
as shown in fig. 5A, the hollow nipple 226 protruding to the distal end is arranged at the peripheral area of the opening 241 in the balloon extension tube; the hollow nipple 226 may be more easily inflated in a forward extending manner as the balloon free portion 22 fills, increasing the range of inflation and extending the axial distance of inflation; FIG. 5B shows the balloon extension tube lumen 240 penetrating the guidewire G; in order to ensure that fluid does not leak from the balloon connection portion 21 during inflation of the balloon, the balloon connection portion 21 is in sealing connection with the outer surface of the endoscope body head 12, the wall thickness of the balloon connection portion 21 is greater than that of the balloon free portion 22, the balloon connection portion 21 and the outer surface of the endoscope body head 12 are preferably in interference fit, the assembled balloon connection portion 21 is located in the sheath gap 130, and the characteristics of the elastic material of the balloon 2 enable the balloon free portion 22 to be pulled by a larger external force, and finally to be separated from the endoscope body head 12 along with the upward deformation of the balloon connection portion 21.
The change in wall thickness reduction after inflation of the balloon free portion 22 is not shown in the drawings of the present invention to clearly show the critical structure.
When the invention is used for kidney stone surgery, a section adjacent to the opening 311 in the sheath body is a bendable section of the sheath body, and/or a section of the endoscope body adjacent to the opening 111 in the working channel is a bendable section of the endoscope (as shown in fig. 1K); the bendable section makes the endoscope difficult to have vision and operation dead angles in the renal pelvis and the renal calyx.
When the ureter lithotripsy system is used for a ureter lithotripsy operation system, the ureter lithotripsy operation system also comprises at least one of a perfusion device (not shown), a lithotripsy optical fiber (not shown), a negative pressure suction device (not shown), a pressure sensor, a temperature sensor (not shown), a lithotripsy basket (not shown) and a guide wire; the pressure sensor and the temperature sensor can be arranged in the adjacent area of the opening 311 in the sheath tube main body, and can also be arranged on the head 12 of the endoscope main body, so that the pressure and the temperature in the urinary tract can be conveniently monitored during operation, and the operation safety is ensured; in order to reduce friction during insertion and operation, the balloon free portion 22, the endoscope body 1, the sheath body 3, and the guide wire G are attached with a hydrophilic coating.
The safe imbedded medical endoscope of the invention remarkably simplifies the operation steps, reduces the tissue damage, saves the operation time and reduces the treatment cost; can be used for medical treatment in various natural cavities including cardiovascular and respiratory tract, auditory canal, lacrimal passage, genital tract and digestive tract, or in third gap such as chest cavity and abdominal cavity of living body, and also can be used for medical treatment of traumata, pathological sinus tract, etc.
Claims (10)
1. A safety implantable medical endoscope apparatus, wherein:
the endoscope comprises an endoscope body (1), wherein an optical component is arranged on the slender endoscope body (1), the endoscope body (1) is provided with a working channel (11) penetrating through the head and the tail, and the working channel (11) is provided with a working channel inner opening (111) which enters the body when in use and a working channel outer opening (112) which is positioned outside the body when in use;
the sheath tube, the slender sheath tube main body (3) is sleeved outside the endoscope main body (1), the sheath tube main body (3) is provided with a sheath tube main body inner opening (311) which enters the body when in use and a sheath tube main body outer opening (312) which is positioned outside the body when in use;
the method is characterized in that: the head top end (121) of the endoscope main body (1) is coated with an expandable balloon (2), the balloon (2) is composed of a balloon connecting part (21) and a balloon free part (22), the balloon connecting part (21) is connected with the outer surface of the head (12) of the endoscope main body (1) in a cylinder shape, the balloon free part (22) is an expandable part of the balloon (2), and a gap between the balloon free part (22) and the head top end (121) of the endoscope main body (1) forms a balloon inner cavity (20); the maximum outer diameter of the inflated balloon free portion (22) is at least greater than the outer diameter of the endoscope body head (12); the free part (22) of the capsule body is transparent or at least the area corresponding to the optical component of the head top (121) of the endoscope main body (1) is transparent; the inner surface area of the bag body free part (22) is connected with a hollow bag body extension tube (24), and the bag body extension tube (24) is provided with a bag body extension tube inner opening (241) and a bag body extension tube outer opening (242); the capsule extension tube (24) can be directly or assisted by a guide wire (G) to penetrate into the endoscope working channel (11), and the tail end of the capsule extension tube (24) penetrates out of the outer opening (112) of the endoscope working channel; fluid can enter the inner cavity (20) of the capsule body through a filling gap (110) between the outer surface of the capsule body extension tube (24) and the inner surface of the working channel (11);
a fastening mechanism (T) which can be tightly connected with the tail part (14) of the endoscope body is arranged near the outer opening (312) of the sheath body, when the endoscope is used, the top end (121) of the head part of the endoscope body (1) protrudes out of the inner opening (312) of the sheath body, at least a part of the free part (22) of the capsule body is exposed outside, and the fastening mechanism (T) is started to tightly connect the sheath body (3) with the endoscope body (1), so that the synchronous advancing and retreating of the endoscope body (1) and the sheath body (3) are realized; when the endoscope main body (1) moves forwards in the natural cavity of the living body and is blocked, fluid can be filled into the inner cavity (20) of the capsule body through the filling gap (110) to expand the free part (22) of the capsule body, and the tissue at the narrow part of the natural cavity is radially and flexibly expanded, so that the endoscope main body (1) can move forwards in the natural cavity after expansion; after the device reaches the target position, the fastening mechanism (T) is loosened, and the endoscope main body (1) can freely rotate or move forwards and backwards in the inner cavity (31) of the sheath main body.
2. A safety implantable medical endoscope apparatus according to claim 1, wherein the balloon free portion (22) is provided with a distally projecting conical projection (228) located in a peripheral region of the inner opening (241) of the balloon extension tube.
3. A safety implantable medical endoscope apparatus according to claim 1, characterized in that a section of the sheath body (3) adjacent to the inner opening (321) of the sheath body is a sheath body bendable section and/or a section of the endoscope body (1) adjacent to the inner opening (111) of the working channel is an endoscope bendable section.
4. A safety implantable medical endoscope apparatus according to claim 1, characterized in that the balloon free portion (22) is provided with a hollow nipple (226) located in the area around the opening (241) in the balloon extension tube, and/or that the balloon free portion (22) is provided with one or more annular folds (227).
5. The medical endoscope apparatus according to claim 1, wherein a reinforcing structure is provided around an inner opening (241) of the balloon extension tube connected to the balloon free portion (22), and comprises at least one of an annular thick-wall reinforcing rib (223), an upper thickening section (224), and a lower thickening section (225).
6. A safety-embedded medical endoscope apparatus according to claim 1, characterized in that the wall thickness and/or the strength of the balloon connection (21) of the balloon (2) is greater than the balloon free portion (22).
7. A safety imbedded medical endoscope apparatus according to claim 1, characterized in that a flexible balloon shielding part (23) which can shield or cover the inner opening outer edge (322) of the sheath main body cavity (31) is extended outwards at the juncture of the balloon free part (22) and the balloon connecting part (21).
8. The safe imbedding type medical endoscope device according to claim 1, wherein a flexible bag shielding part (23) capable of shielding an inner opening outer edge (322) of the inner cavity (31) of the sheath tube main body extends outwards from the junction of the bag body free part (22) and the bag body connecting part (21), the flexible bag body shielding part (23) is provided with a cylindrical flanging (232), and the cylindrical flanging (232) is used for wrapping the inner opening outer edge (322).
9. A safety imbedded medical endoscope apparatus according to claim 1, characterized in that the working channel outer opening (112) is connected with a hollow elastic power bag (5), the elastic power bag (5) is extruded to fill the fluid in the elastic power bag into the bag inner cavity (20) so as to expand the bag body free part (22); the fluid in the inner cavity (20) of the bag body after the extrusion is released flows back to the inner cavity (50) of the elastic power bag.
10. A transureteral lithotripsy system comprising the safety implantable medical endoscopic device of any of claims 1-9, further comprising at least one of a perfusion device, a lithotripsy fiber, a negative pressure suction device, a pressure sensor, a temperature sensor, a stone basket, a guide wire.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202311162678.5A CN116982912A (en) | 2023-09-10 | 2023-09-10 | Safe-placement medical endoscope device and ureteral lithotripsy operation system |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202311162678.5A CN116982912A (en) | 2023-09-10 | 2023-09-10 | Safe-placement medical endoscope device and ureteral lithotripsy operation system |
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| CN116982912A true CN116982912A (en) | 2023-11-03 |
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| CN202311162678.5A Pending CN116982912A (en) | 2023-09-10 | 2023-09-10 | Safe-placement medical endoscope device and ureteral lithotripsy operation system |
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| Country | Link |
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| CN (1) | CN116982912A (en) |
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- 2023-09-10 CN CN202311162678.5A patent/CN116982912A/en active Pending
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