CN117138204A - Medical sheath tube, ureter guiding sheath and ureter operation system - Google Patents

Medical sheath tube, ureter guiding sheath and ureter operation system Download PDF

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Publication number
CN117138204A
CN117138204A CN202311160258.3A CN202311160258A CN117138204A CN 117138204 A CN117138204 A CN 117138204A CN 202311160258 A CN202311160258 A CN 202311160258A CN 117138204 A CN117138204 A CN 117138204A
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CN
China
Prior art keywords
sheath
channel
secondary channel
medical
main body
Prior art date
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Pending
Application number
CN202311160258.3A
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Chinese (zh)
Inventor
韩铁工
董东生
李亚舟
张宁
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Anhui Xingfu Gongchang Medical Equipment Co ltd
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Anhui Xingfu Gongchang Medical Equipment Co ltd
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Application filed by Anhui Xingfu Gongchang Medical Equipment Co ltd filed Critical Anhui Xingfu Gongchang Medical Equipment Co ltd
Priority to CN202311160258.3A priority Critical patent/CN117138204A/en
Publication of CN117138204A publication Critical patent/CN117138204A/en
Pending legal-status Critical Current

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0194Tunnelling catheters
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/0021Catheters; Hollow probes characterised by the form of the tubing
    • A61M25/0023Catheters; Hollow probes characterised by the form of the tubing by the form of the lumen, e.g. cross-section, variable diameter
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M2025/0001Catheters; Hollow probes for pressure measurement
    • A61M2025/0002Catheters; Hollow probes for pressure measurement with a pressure sensor at the distal end
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0194Tunnelling catheters
    • A61M2025/0197Tunnelling catheters for creating an artificial passage within the body, e.g. in order to go around occlusions

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biophysics (AREA)
  • Pulmonology (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

The invention discloses a medical sheath tube, a ureter guiding sheath and a ureter operation system, and relates to the field of medical instruments. The invention has novel and reasonable structure, can realize the basic guiding function of the sheath by arranging the main channel, can meet the fluid perfusion or the passing function of the surgical instrument of the sheath by arranging the secondary channel, and simultaneously, as the free part of the secondary channel can deform according to different application scenes, the closable function of the secondary channel is realized, the secondary channel is arranged on the outer wall of the sheath main body and can not enlarge the outer diameter of the sheath main body, the secondary channel is arranged on the inner wall of the sheath main body and can not occupy the space of the main channel in the sheath main body, thereby effectively avoiding the influence of the secondary channel on the normal passing of the instrument or the fluid in the main channel, and meeting the requirements of the sheath with the smallest outer diameter and the largest inner diameter of the sheath as much as possible in clinic.

Description

Medical sheath tube, ureter guiding sheath and ureter operation system
Technical Field
The invention relates to the field of medical instruments, in particular to a medical sheath tube, a ureter guiding sheath and a ureter operation system.
Background
In the medical field, common sheaths include arterial sheaths, ureteral sheaths, and the like, which are used to provide access to related surgical materials or instruments.
For example, ureteral sheaths are often used in urologic surgery (e.g., urolithiasis), and can provide access to related surgical instruments such as endoscopes. Among them, ureteral sheath tube with perfusion function is most widely used; however, because the perfusion channel additionally arranged on the sheath is often a rigid channel, the arrangement of the perfusion channel on the outer wall of the sheath can increase the overall outer diameter of the sheath, reduce the suitability of the sheath and the ureter and other human body cavities, and increase the operation difficulty and the operation risk; the perfusion channel is arranged on the inner wall of the sheath, so that the inner space of the sheath is sacrificed, the trafficability of surgical instruments and the like in the sheath is influenced, and the surgical effect and the surgical efficiency are influenced.
To sum up, whatever perfusion channel design scheme on the existing sheath tube cannot meet the clinical requirements: the sheath tube has the smallest outer diameter and the largest inner diameter, so that a novel medical sheath tube design scheme is necessary to overcome the defects of the prior sheath tube.
Disclosure of Invention
The invention aims to provide a medical sheath, a ureter guiding sheath and a ureter operation system, which are used for solving the problem that the design scheme of the perfusion channel on the existing sheath cannot meet clinical requirements: the sheath outside diameter is as small as possible and the sheath inside diameter is as large as possible.
In order to achieve the above object, the present invention provides the following solutions:
the invention provides a medical sheath tube, which comprises a sheath tube main body, wherein the sheath tube main body is provided with:
the main channel is arranged in the sheath tube main body and is used for allowing fluid or surgical instruments to pass through;
a secondary channel comprising a free portion that is easily deformed and a connecting portion that contacts the sheath body, the secondary channel having a channel inlet and a channel outlet; when the initial state of the secondary channel is a closed state, the free part can be deformed by filling fluid or a surgical instrument so as to prop up the secondary channel to an open state; when the initial state of the secondary channel is an open state, the free part can be deformed by being pressed by external force so as to press the secondary channel to be in a closed state.
Optionally, the main channel extends along an axial direction of the sheath body and penetrates through two axial ends of the sheath body.
Optionally, the secondary channel is formed by connecting at least one long sheet-shaped secondary channel component with the tube wall of the sheath tube main body, the connection part is formed at the connection part of the secondary channel component and the sheath tube main body, and the rest parts of the secondary channel component form the free part; the secondary channel is provided with the channel inlet at a position close to the axial first end of the sheath body, and the secondary channel is provided with the channel outlet at a position close to the axial second end of the sheath body.
Optionally, the secondary channel is formed by sleeving or sleeving a long thin-wall tubular secondary channel part and the sheath body, the connection part is formed at the connection part of the secondary channel part and the tube wall of the sheath body, and the free part is formed at the rest part of the secondary channel part; the secondary channel is provided with the channel inlet at a position close to the axial first end of the sheath body, and the secondary channel is provided with the channel outlet at a position close to the axial second end of the sheath body.
Optionally, the secondary channel is formed by connecting at least one thin-wall fire-fighting water ribbon-shaped secondary channel component with the tube wall of the sheath tube main body, the connection part is formed at the connection part of the secondary channel component and the sheath tube main body, and the tube wall of the secondary channel component forms the free part; the secondary channel is provided with the channel inlet at a position close to the axial first end of the sheath body, and the secondary channel is provided with the channel outlet at a position close to the axial second end of the sheath body.
Optionally, the secondary channel member is integrally formed with the sheath body.
Optionally, the secondary channel is formed by a thin-wall protruding part formed by co-extrusion with the sheath body, and the thin-wall protruding part serves as the free part and protrudes into or out of the cavity of the sheath body.
Optionally, the secondary channel extends along the axial direction of the sheath body, and the secondary channel is disposed on the outer wall or the inner wall of the sheath body, or is disposed on the outer wall and the inner wall of the sheath body at the same time.
Optionally, the secondary channel member is integrally formed with the sheath body.
Optionally, the secondary channel component is folded at the axial second end of the sheath body to form a folded part, the folded part wraps the axial second end of the sheath body from the inner side and the outer side, and the channel outlet is opened at the folded part.
Optionally, the channel outlets are distributed at least one of the first position, the second position and the third position of the turnup; the first position is located on the part of the turnover part located on the outer wall of the sheath pipe main body, the second position is located on the part of the turnover part located on the inner wall of the sheath pipe main body, and the third position is located at the turnover part of the turnover part.
Optionally, the two ends of the secondary channel part extend to the two axial ends of the sheath body respectively, and are not longer than the two axial ends of the sheath body.
Optionally, the connection portion is formed by combining one or more of a point connection portion, a sheet connection portion and a linear connection portion.
Optionally, a temperature sensor and/or a pressure sensor are further arranged on the sheath tube main body.
Optionally, the sheath tube main body is provided with one secondary channel; alternatively, the sheath body may be provided with a plurality of the secondary channels along a circumferential direction thereof.
Optionally, the sheath body is uniformly distributed with a plurality of secondary channels along the circumferential direction of the sheath body.
Optionally, one end of the sheath body for extending into the body cavity is provided as a bendable section.
Optionally, the medical sheath is a vascular sheath, an airway sheath, a lacrimal sheath, an ear canal sheath, a digestive tract sheath or a ureteral sheath.
Optionally, a hydrophilic coating is attached to the inner wall surface and/or the outer wall surface of the sheath body.
The invention also provides a ureteral guiding sheath, which comprises a joint and the medical sheath tube, wherein the joint is provided with a guiding channel, one end of the guiding channel is sleeved at one axial end of the sheath tube main body through a tube connecting structure, and the tube connecting structure is provided with a buffer cavity in sealing butt joint with the channel inlet; and the joint is also provided with a filling port communicated with the buffer cavity and a fluid discharge port communicated with the main channel.
Optionally, the fluid outlet is provided with a pressure regulating structure.
Optionally, the buffer cavities are arranged in one-to-one correspondence with the secondary channels, all the buffer cavities are isolated from each other, and any one buffer cavity is correspondingly communicated with one filling port;
or, the buffer cavity is a continuous annular cavity channel arranged along the circumferential direction of the sheath tube main body, and the channel inlet of any secondary channel is communicated with the buffer cavity.
Optionally, an end of the sheath tube main body facing away from the tube connection structure is provided as a bendable section, and the ureteral guiding sheath further comprises a bending adjustment mechanism for controlling the bending degree of the bendable section.
Optionally, the bending adjustment mechanism is disposed on the joint.
The invention also provides a ureteral operation system, which comprises the ureteral guide sheath, and further comprises at least one of perfusion equipment, an endoscope, a lithotripsy optical fiber, a long conical inner core, negative pressure suction equipment and a guide wire.
Optionally, the ureteral guiding sheath comprises a long conical inner core, and the long conical inner core is sleeved in the main channel of the medical sheath.
Optionally, a hydrophilic coating is attached to the front end of the long conical inner core.
Compared with the prior art, the invention has the following technical effects:
the medical sheath tube provided by the invention has novel and reasonable structure, can realize the basic guiding function of the sheath tube by arranging the main channel, is mainly used for the passage of medical instruments, and provides guiding, protecting and other corresponding functions for the medical instruments positioned in the sheath tube, such as various soft lenses, various hard lenses, various non-endoscope catheters and the like; simultaneously, because the free part of the secondary channel can deform according to different application scenes, the closable function of the secondary channel is realized, the normal channel function of the secondary channel can be reserved when the secondary channel is opened, the free part which is easy to deform can deform and be attached to the pipe wall (inner wall or outer wall) of the sheath main body when the secondary channel is closed, the outer diameter of the sheath main body cannot be enlarged when the secondary channel is arranged on the outer wall of the sheath main body, the space of the main channel in the sheath main body cannot be occupied when the secondary channel is arranged on the inner wall of the sheath main body, the influence of the secondary channel on normal passage of the instrument or fluid in the main channel can be effectively avoided, and the requirements that the outer diameter of the sheath is as small as possible and the inner diameter of the sheath is as large as possible in clinic are met.
In some aspects of the disclosure, the distal end of the medical sheath is provided with a bendable section. By adopting the flexible design scheme, the problem that the traditional sheath tube cannot be bent to cause the damage to the human body cavity such as ureter and blood vessel is solved, and meanwhile, the problem that the lavage liquid is not smoothly drained in the operation due to the fact that the sheath placement position is not in place can be avoided, and the efficiency and the safety of the operation can be improved.
The ureteral guiding sheath provided by the invention comprises the medical sheath tube, has all the characteristics of the medical sheath tube, and is not described in detail.
The ureteral operation system provided by the invention has the characteristics of a medical sheath tube, and is not described in detail.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings that are needed in the embodiments will be briefly described below, and it is obvious that the drawings in the following description are only some embodiments of the present invention, and other drawings may be obtained according to these drawings without inventive effort for a person skilled in the art.
Fig. 1 is a schematic view of the overall structure of a ureteral surgical system according to an embodiment of the present invention;
Fig. 2 is a schematic cross-sectional view of the ureteral surgical system of fig. 1;
FIG. 3 is an enlarged schematic view of FIG. 2A;
fig. 4 is a schematic view of the overall structure of a ureteral introducer sheath without a bending adjustment mechanism according to an embodiment of the present invention;
fig. 5 is a schematic cross-sectional view of the ureteral introducer sheath of fig. 4;
fig. 6 is a schematic view of the overall structure of a ureteral introducer sheath with a bend adjustment mechanism according to an embodiment of the present disclosure;
fig. 7 is a schematic cross-sectional view of the ureteral introducer sheath of fig. 6;
FIG. 8 is an enlarged schematic view of the structure shown at B in FIG. 7;
FIG. 9 is a schematic diagram of a secondary channel end outlet in a sheath body according to an embodiment of the present invention;
FIG. 10 is a schematic diagram of the structure of the water outlet outside the secondary channel in the sheath body according to the embodiment of the present invention;
FIG. 11 is a schematic diagram of a structure in which the end and the outer side of the secondary channel in the sheath body are simultaneously discharged according to the embodiment of the present invention;
FIG. 12 is a schematic view showing a secondary channel according to an embodiment of the present invention disposed on an inner wall of a sheath body;
FIG. 13 is a schematic view illustrating a secondary channel according to an embodiment of the present invention disposed on an outer wall of a sheath body;
FIG. 14 is a schematic cross-sectional view of a sheath body according to an embodiment of the present invention;
FIG. 15 is a schematic view of a structure of a hinge disclosed in an embodiment of the present invention, wherein a channel outlet is provided at the hinge;
FIG. 16 is a schematic diagram of the outlet of the channel shown in FIG. 15;
FIG. 17 is a schematic view of a structure of a hinge disclosed in an embodiment of the present invention, wherein a channel outlet is provided at both the hinge and the outside;
FIG. 18 is a schematic diagram of the outlet of the channel of FIG. 17;
FIG. 19 is a schematic view of a structure in which channel outlets are simultaneously disposed at a turnup and outside of a turnup, and the channel outlets are spirally distributed outside the turnup according to an embodiment of the present invention;
FIG. 20 is a schematic diagram of the outlet of the channel of FIG. 19;
FIG. 21 is a schematic view of a structure of a sheath body with secondary channels formed on the inner wall thereof and a turnover part according to an embodiment of the present invention;
FIG. 22 is an enlarged schematic view of FIG. 21C;
FIG. 23 is a schematic view showing the structure of section D-D of FIG. 21 when the secondary channel member is a long sheet channel member according to an embodiment of the present invention;
FIG. 24 is a schematic view showing the structure of section D-D of FIG. 21 when the secondary channel member is a long thin-walled tubular channel member according to an embodiment of the present invention;
FIG. 25 is a schematic view of the cross-sectional D-D structure of FIG. 21 when the secondary channel element disclosed in the embodiment of the present invention is a thin-walled fire-fighting water ribbon channel element;
FIG. 26 is a schematic cross-sectional view of a secondary channel according to an embodiment of the present invention when the inner wall of the sheath body is uniformly circumferentially distributed;
FIG. 27 is a schematic cross-sectional view of a secondary channel according to an embodiment of the present invention when the outer wall of the sheath body is uniformly circumferentially distributed;
FIG. 28 is a schematic view of a connection portion of a secondary channel according to an embodiment of the present invention;
fig. 29 is a schematic structural view of a connection portion of a secondary channel according to an embodiment of the present invention;
FIG. 30 is a schematic view of a connection portion of a secondary channel according to an embodiment of the present invention;
fig. 31 is a schematic view of the operation of a disclosed guidewire in accordance with an embodiment of the present invention as it is deployed into the renal pelvis;
fig. 32 is a schematic view of the ureteral introducer sheath of the present disclosure as it is being placed along a guidewire into the renal pelvis;
fig. 33 is a schematic view of a ureteral introducer sheath according to an embodiment of the present invention after placement in the renal pelvis;
fig. 34 is a schematic view of a ureteral introducer sheath according to an embodiment of the present disclosure, with the sheath body reaching a stone;
fig. 35 is a schematic view of the operation of the disclosed lithotripsy fiber along the main passageway of the sheath body into the renal pelvis in accordance with an embodiment of the present invention;
Fig. 36 is a schematic view illustrating an operation of the endoscope when the distal end of the endoscope is withdrawn from the sheath body according to the embodiment of the present invention.
Wherein, the reference numerals are as follows:
100. a ureteral surgical system; 200. a ureteral introducer sheath;
1. a sheath body; 11. a sensor mounting hole; 12. a bendable section;
2. a main channel;
3. a secondary channel; 31. a free portion; 32. a connection part; 321. a dot-shaped connection part; 322. a sheet-like connection portion; 323. a linear connection portion; 33. a channel inlet; 34. a channel outlet; 35. a long sheet passage member; 36. a long thin-walled tubular passage member; 37. a thin-walled fire-hose channel component; 38. a turnover part;
4. a joint; 41. a guide channel; 42. a tube connection structure; 421. a buffer chamber; 43. a filling port; 44. a fluid discharge port; 45. a pressure regulating structure; 46. a sealing cap;
5. a bend adjustment mechanism; 51. a traction rope;
6. a long conical inner core;
7. renal pelvis;
8. a guide wire.
Detailed Description
The following description of the embodiments of the present invention will be made clearly and completely with reference to the accompanying drawings, in which it is apparent that the embodiments described are only some embodiments of the present invention, but not all embodiments. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.
The invention aims to provide a medical sheath tube to solve the problem that the design scheme of a perfusion channel on the existing sheath tube cannot meet clinical requirements: the sheath outside diameter is as small as possible and the sheath inside diameter is as large as possible.
Another object of the present invention is to provide a ureteral introducer sheath having the above medical sheath.
It is still another object of the present invention to provide a ureteral surgical system having the ureteral introducer sheath described above.
In order that the above-recited objects, features and advantages of the present invention will become more readily apparent, a more particular description of the invention will be rendered by reference to the appended drawings and appended detailed description.
Example 1
As shown in fig. 1 to 14, the present embodiment provides a medical sheath, including a sheath body 1, where the sheath body 1 has a main channel 2 and a secondary channel 3 at the same time, and the main channel 2 is opened in the sheath body 1 to form an inner cavity of the sheath body 1, and the main channel 2 is generally arranged along an axial direction of the sheath body 1 and is used for passing fluid or a surgical instrument; the secondary channel 3 includes a free portion 31 which is easily deformed and a connection portion 32 which is in contact with and connected to the sheath body 1, the secondary channel 3 has a channel inlet 33 and a channel outlet 34, when the initial state of the secondary channel 3 is a closed state, the free portion 31 can be deformed by filling fluid or a surgical instrument into the secondary channel through the channel inlet 33 to prop the secondary channel 3 open, whereas when the initial state of the secondary channel 3 is an open state, the secondary channel 3 can be deformed by external force (when the secondary channel 3 is arranged on the inner wall of the sheath body 1, so-called "external force" is the pressing force to the secondary channel 3 when the fluid or the surgical instrument is normally introduced into the primary channel 2, and when the secondary channel 3 is arranged on the outer wall of the sheath body 1, so-called "external force" is the pressing force to the natural cavity of the human body which the outer periphery of the sheath body 1 is subjected to) to press the secondary channel 3 to the closed state. The medical sheath can realize the basic guiding function of the sheath by arranging the main channel 2, is mainly used for the passage of medical instruments, and provides guiding, protecting and other corresponding functions for the medical instruments positioned in the sheath, such as various soft lenses, various hard lenses, various non-endoscope catheters and the like; simultaneously, as the free part 31 of the secondary channel 3 can deform according to different application scenes, the closable function of the secondary channel 3 is realized, the normal channel function of the secondary channel 3 is reserved by opening the secondary channel 3, the free part 31 which is easy to deform can deform to be attached to the pipe wall (inner wall or outer wall) of the sheath main body 1 when the secondary channel 3 is closed, the outer diameter of the sheath main body 1 cannot be enlarged when the secondary channel 3 is arranged on the outer wall of the sheath main body 1, the space of the main channel 2 in the sheath main body 1 cannot be occupied by the secondary channel 3, and the influence of the secondary channel on the normal passage of the instrument or fluid in the main channel 2 can be effectively avoided. It should be noted that, according to actual use requirements, the fluids that can be communicated in the main channel 2 and the secondary channel 3 may be the same or different, and the fluids may be liquid, liquid-solid mixed state or paste state with flowing performance, the secondary channel 3 is mainly perfusate, and the main channel 2 is generally filled with a washing liquid or perfusate containing impurities such as stones, pathological tissues and the like.
The secondary channel 3 is closed, and does not mean that the channel inlet 33 and the channel outlet 34 of the secondary channel 3 are closed to the outside communication state, but means that the internal space of the secondary channel 3 is eliminated, so that the internal space of the main channel 2 is not occupied or the outer diameter of the sheath body 1 is enlarged.
In this embodiment, the two ends of the main channel 2 are open, and the two end openings of the main channel 2 may be located at two axial end portions of the sheath body 1 (i.e., the two ends of the main channel 2 are respectively disposed through two axial ends of the sheath body 1), at this time, the sheath body 1 is a pipe with two open ends. The sheath body 1 may have at least one closed end, and the opening of the main channel 2 at the corresponding end is opened at the side wall of the sheath body 1 near the closed end. As a preferable scheme, two ends of the main channel 2 in the scheme respectively penetrate through two axial ends of the sheath tube main body 1, and the channel wall of the main channel 2 is the inner wall of the sheath tube main body 1. The primary channel 2 has a larger average cross-sectional area or internal volume than the secondary channel 3 in the situation of use.
In this embodiment, the secondary channel 3 may be provided only on the outer wall of the sheath body 1, only on the inner wall of the sheath body 1, or both the inner and outer walls of the sheath body 1. In view of the small diameter of the sheath body 1 itself and high requirement for dimensional accuracy of the structure, it is generally only necessary to provide the secondary channel 3 on the outer wall or the inner wall of the sheath body 1.
Further, in this embodiment, the secondary channel 3 is formed by connecting at least one long sheet-like secondary channel component with the tube wall (inner wall or outer wall) of the sheath tube main body 1, the secondary channel component is a long sheet-like channel component 35, the connection portion 32 is formed at the connection portion of the long sheet-like channel component 35 and the sheath tube main body 1, the rest portion of the long sheet-like channel component 35 is not connected with the sheath tube main body 1 to form the free portion 31, the size of the gap between the free portion 31 and the tube wall of the sheath tube main body 1 is different according to the deformation state of the free portion 31, and it should be noted that the deformation of the free portion 31 can be realized by the elastic property of the material of the long sheet-like channel component 35 itself, for example, the long sheet-like channel component 35 is made of a compliant material (such as PVC, latex, silica gel) or a semi-compliant material, and the elastic deformation of the long sheet-like channel component 35 is mainly represented by a thinned wall thickness and a volume. The deformation of the free portion 31 may also be achieved by changing the position of the free portion 31, for example, the long sheet channel member 35 is made of a non-compliant material (such as Polyethylene (PE), polyurethane, nylon (Nylon, duralynTM) and polyethylene terephthalate), at this time, the long sheet channel member 35 has poor elasticity, and is attached to the wall of the sheath body 1, so that the free portion 31 can be closed, and fluid or an instrument is introduced into the secondary channel 3, so that the free portion 31 can be expanded, and when the free portion 31 is switched between the closed state and the expanded state, the wall thickness is basically unchanged, but is driven by an external force to change the position, thereby changing the shape. As can be seen from the above description, the difference between the non-compliant material and the semi-compliant material is that the free portion 31 made of the compliant material and the semi-compliant material can automatically rebound to be attached to the wall of the sheath body 1 after the fluid or the instrument is withdrawn, so as to realize the closing, and the free portion 31 made of the non-compliant material can be restored to be attached to the wall of the sheath body 1 by an external force after the fluid or the instrument is withdrawn, so as to realize the closing. The secondary channel 3 is closed to the extent that it can be fully closed or can be mostly closed, at least without significantly affecting the internal space of the primary channel 2 or excessively increasing the outer diameter of the sheath body 1.
In general, the long sheet passage member 35 extends in the axial direction of the sheath body 1, and may be parallel to the axial direction of the sheath body 1 or may be spirally wound around the axis of the sheath body 1 on the wall of the sheath body 1. Preferably, the long sheet passage member 35 is arranged parallel to the axial direction of the sheath body 1, and correspondingly, the secondary passage 3 formed between the long sheet passage member 35 and the sheath body 1 is also arranged parallel to the axial direction of the sheath body 1. Both sides in the width direction of the long sheet passage member 35 are connected to the wall of the sheath body 1 to form the connection portions 32, and the connection portions 32 extend entirely in the axial direction of the sheath body 1, and in general, the number of secondary passages 3 formed between one long sheet passage member 35 and the sheath body 1 can be adjusted by changing the number of connection portions 32 formed by connection between the long sheet passage member 35 and the sheath body 1, and it is generally preferable that only one secondary passage 3 is formed between one long sheet passage member 35 and the sheath body 1 every two adjacent connection portions 32. The secondary channel 3 is provided with a channel inlet 33 at a position close to the axial first end (the end far from the affected part and close to the doctor, also called as "proximal end") of the sheath body 1 during operation, and the secondary channel 3 is provided with a channel outlet 34 at a position close to the axial second end (the end far from the doctor, also called as "distal end") of the sheath body 1 during operation. The channel inlet 33 and the channel outlet 34 may be formed in the free portion 31 of the long sheet channel member 35 or may be formed in the wall of the sheath body 1 at the corresponding position, depending on the positions of the long sheet channel member 35 provided on the inner and outer walls of the sheath body 1.
Further, in this embodiment, a long sheet channel member 35 may be provided on the sheath body 1 according to actual needs, and a secondary channel 3 is correspondingly formed, and since the sheath body 1 is generally a circular tube, it is preferable that the secondary channel 3 spans 1/4 to 1/3 of the circular arc of the entire circumference of the sheath body 1. Accordingly, a plurality of long sheet passage members 35 may be arranged on the sheath body 1 in the circumferential direction thereof as required, each long sheet passage member 35 forming one secondary passage 3. As a further preferable aspect, when a plurality of secondary channels 3 are provided on the sheath body 1, they are preferably uniformly distributed at intervals along the circumferential direction of the sheath body 1.
In the present embodiment, the connection portion 32 formed by connecting the long sheet passage member 35 to the wall of the sheath body 1 is preferably formed by combining one or more of the dot-shaped connection portion 321, the sheet-shaped connection portion 322, and the linear connection portion 323. As shown in fig. 28, the connecting portion 32 is formed by a single longer linear connecting portion 323 or by a plurality of shorter linear connecting portions 323 connected in series; as shown in fig. 29, the connection portion 32 is formed by a plurality of dot-shaped connection portions 321 arranged along the axial direction of the sheath main body 1; as shown in fig. 30, the connecting portion 32 is formed by a single long sheet-like connecting portion 322 or by a plurality of short sheet-like connecting portions 322 connected in series, and the sheet-like connecting portion 322 has a larger width and is more firmly connected than the linear connecting portion 323. In addition to the above arrangement, the connection portion 32 may be formed by a combination of a plurality of the dot-shaped connection portion 321, the sheet-shaped connection portion 322, and the linear connection portion 323, such as half of the dot-shaped connection portion 321 and the other half of the linear connection portion 323; the dot-shaped connecting portions 321, the sheet-shaped connecting portions 322, and the linear connecting portions 323 constituting the connecting portion 32 may be regularly arranged or irregularly arranged as required, as long as the secondary channel 3 can be sealed. The dot-shaped connecting portion 321, the sheet-shaped connecting portion 322, and the linear connecting portion 323 may be directly connected to the sheath body 1 by the long sheet passage member 35 by a bonding or welding process, or may be connected by other connecting members.
In the actual production process, the long sheet channel member 35 may also be directly integrally formed with the sheath body 1, such as integrally extruded, where the long sheet channel member 35 is closed with the sheath body 1 is used as the connecting portion 32, and where the long sheet channel member 35 is separated from the sheath body 1 is used as the engaging and disengaging portion 31 of the long sheet channel member 35.
In this embodiment, the two ends of the long sheet channel member 35 generally extend to the two axial ends of the sheath body 1 respectively and are not longer than the two axial ends of the sheath body 1, and correspondingly, the secondary channel 3 also extends to the two axial ends of the sheath body 1 and is not longer than the two axial ends of the sheath body 1. As shown in fig. 9 to 11, in the structure in which the long sheet channel member 35 is provided on the inner wall of the sheath body 1, one end of the long sheet channel member 35 near the proximal end of the sheath body 1 is closely connected to the inner wall of the sheath body 1, and the channel inlet 33 of any one of the secondary channels 3 is provided on the side wall of the proximal end of the sheath body 1 and communicates with the inside of the secondary channel 3; one end of the long sheet channel member 35, which is close to the distal end of the sheath body 1, may be in close connection with the inner wall of the sheath body 1, and at this time, the channel outlets 34 of any secondary channels 3 are all formed on the side wall of the distal end of the sheath body 1, so as to realize the water outlet mode of the outer side of the distal end of the sheath. The end of the long sheet channel member 35 near the distal end of the sheath tube main body 1 may also be arranged with an opening (i.e., the long sheet channel member 35 is not closed with the inner wall of the sheath tube main body 1), and the opening is used as the channel outlet 34 to directly drain liquid, so as to realize the water outlet mode of the distal end of the sheath tube; in order to improve the flushing effect, the rotary suction effect and the like caused by the liquid outlet at the distal end of the sheath tube, the channel outlet 34 is formed on the side wall of the distal end of the sheath tube main body 1 on the basis of keeping the opening of the end part of the secondary channel 3, so that the mode of simultaneously discharging water at the outer side part and the end part of the distal end of the sheath tube is realized. According to the use requirement, a channel outlet 34 can be formed in the free part of the long sheet channel part 35, which is close to the distal end of the sheath tube main body 1, so as to realize the internal water outlet of the distal end of the sheath tube, and the internal water outlet mode can be simultaneously realized by matching with the end water outlet mode and the outer side water outlet mode. When the side wall of the distal end of the sheath tube main body 1 is provided with the channel outlets 34, the channel outlets 34 can be uniformly distributed in the axial direction and the circumferential direction of the sheath tube main body 1, and can also be spirally distributed around the axial direction of the sheath tube main body 1 so as to realize rotational flow water outlet. The addition of the channel outlet 34 to the distal sidewall of the sheath body 1 may allow the distal end of the sheath body 1 to be more flexible and more easily bent through UPJ into the non-straight tract of the renal pelvis, etc.
When the long sheet channel member 35 is disposed on the inner wall of the sheath tube body 1, in addition to the above-described arrangement form of the long sheet channel member 35, one end of the long sheet channel member 35 located at the distal end of the sheath tube body 1 may be further folded and connected with the distal end of the sheath tube body 1 to form a folded portion 38, the folded portion 38 wraps the distal end of the sheath tube body 1 from the inner side and the outer side, the channel outlet 34 is opened in the folded portion 38, and specifically, the channel outlet 34 is distributed in at least one of a first position, a second position and a third position of the folded portion 38, where the first position is located on a portion of the folded portion 38 located on the outer wall of the sheath tube body 1, the second position is located on a portion of the folded portion 38 located on the inner wall of the sheath tube body 1, and the third position is located at the folded portion 38. As shown in fig. 15 and 16, the channel outlet 34 is opened at the third position of the turndown 38, that is, the channel outlet 34 is located at the turndown position of the turndown 38, so that the water outlet mode of the distal end of the sheath tube can be realized. As shown in fig. 17 and 18, the channel outlet 34 is opened at the first position and the third position of the turnup portion 38 at the same time, that is, the channel outlet 34 is located at the portion of the turnup portion 38 located at the outer wall of the sheath body 1 and the turnup portion of the turnup portion 38, so that the mode of simultaneously discharging water from the outer side and the end of the distal end of the sheath can be realized. As shown in fig. 19 and 20, the difference from the solutions shown in fig. 17 and 18 is that the channel outlets 34 are spirally distributed on the portion of the turnup 38 located on the outer wall of the sheath tube main body 1, so that when the mode of simultaneously discharging water from the outer side and the end of the distal end of the sheath tube is realized, the rotational flow water discharge can be further realized. When the long sheet channel member 35 is connected to the distal end of the sheath body 1 by folding, the inner and outer sides of the sheath body 1 are communicated by providing a water hole in the wall of the sheath body 1, as shown in fig. 17, the end of the long sheet channel member 35 and the inner wall of the distal end of the sheath body 1 are sealed to form an inner sealing portion, and then folded outwards, and finally the edge of the end of the long sheet channel member 35 and the outer wall of the distal end of the sheath body 1 are sealed to form an outer sealing portion, as shown in fig. 17, a height difference is formed between the outer sealing portion and the inner sealing portion, the inner sealing portion is located above the outer sealing portion, and a water hole is provided in the side wall of the sheath body 1 between the inner sealing portion and the outer sealing portion, so that the liquid in the secondary channel 3 in the sheath body 1 is drained into the cavity between the distal end of the sheath body 1 and the folded portion 38, and then the liquid is discharged through the folded portion 38 or the outer channel outlet 34.
In this embodiment, when the long sheet channel member 35 is disposed on the outer wall of the sheath body 1, the form (including the form of forming the turndown portion and the form of forming the turndown portion of the long sheet channel member 35 extending only to the end of the sheath body 1, and not forming the turndown portion) is substantially the same as that when the long sheet channel member 35 is disposed on the inner wall of the sheath body 1, the difference is that the long sheet channel member 35 is disposed outside the sheath body 1, the opening position of the channel outlet 34 is adaptively changed (the channel outlet 34 is mostly directly opened on the free portion of the long sheet channel member 35), and the rest is the same as that when the long sheet channel member 35 is disposed on the inner wall of the sheath body 1, which will not be described in detail.
It should be noted that the long sheet passage member 35 is a layer of a complete material that is attached to the wall of the sheath body 1 so as not to leak. The cross section of the formed secondary channel 3 can be any shape such as a circle, an ellipse and the like in the open state.
In this embodiment, a temperature sensor and/or a pressure sensor may be further provided on the sheath body 1 as needed. As shown in fig. 14, a sensor mounting hole 11 is formed in the wall of the sheath tube body 1, and a temperature sensor and/or a pressure sensor can be mounted.
In this embodiment, the sheath body 1 may be provided as a tearable sheath (also referred to as a tearable sheath). The inner wall surface and/or the outer wall surface of the sheath body 1 may be further provided with a hydrophilic coating.
In this embodiment, the medical sheath may be applied in a natural lumen including a blood vessel, an airway, a lacrimal passage, an auditory canal, and a digestive tract, or in a third gap of a living body, as required, that is, the medical sheath may be used as a vascular sheath, an airway sheath, a lacrimal passage sheath, an auditory canal sheath, a digestive canal sheath, or a ureteral sheath, so as to achieve different clinical use forms.
In the use process of the medical sheath, when the medical instrument in the main channel 2 completely withdraws or retreats to the near end position of the main channel 2, fluid can be injected into the secondary channel 3 from outside the body and flows out through the channel outlet 34 of the secondary channel 3, so as to play the corresponding medical roles of flushing, antibiosis, anticoagulation and the like; a tubular medical tool may also be inserted through the secondary channel 3 for medical purposes such as aspiration, irrigation, drug delivery, image acquisition, tissue ablation, etc. The principle and effect of the use of the medical sheath as a ureteral sheath will be described specifically below by taking the aforementioned medical sheath as an example of a urological operation.
In the medical sheath, since the free portion 31 in each secondary channel 3 is in a closable structure, a dynamic gap (which can be opened or closed as required) is formed between the free portion 31 and the inner wall of the sheath body 1. When the endoscope (generally, a soft mirror) works in the main channel 2 of the sheath tube main body 1, and when no liquid is injected into the secondary channel 3, the free part 31 of the endoscope is in an attached state tightly attached to the inner wall of the sheath tube main body 1, so that the inner space of the main channel 2 is basically not occupied; when the broken stone reaches a certain degree, the endoscope moves back to the near end of the main channel 2, a large enough space is reserved for attracting the broken stone, and meanwhile, liquid is poured into the secondary channel 3 through the channel inlet 33, so that the free part 31 of the secondary channel 3 is expanded by water pressure to be in a free state for fluid pouring, in the pouring process, the deformation characteristics of the free part 31 can be combined, the expansion degree of the free part 31 is controlled by controlling the size of the fluid flow, and then the size of the space in the main channel 2 is controlled, so that the requirement of balanced pouring amount and fluid discharge amount in operation is met. Through the scheme, the ureteral sheath tube not only can discharge gravels with larger sizes, but also can realize the continuous perfusion function, so that the fluid perfusion and the fluid discharge in the operation are carried out simultaneously; meanwhile, the secondary channel 3 adopts a closable design, and can be kept in a closed state when fluid is not filled, so that the problems that the prior perfusion channel is formed on the wall of the sheath, the volume is fixed, the volume can not be reduced even if the fluid is not filled, the space in the sheath is occupied, and the operation of a soft lens is influenced are solved.
In addition, in most cases, the initial state of the secondary channel 3 is a closed state, no gas stays in the channel, and the gas is not brought into the renal pelvis during perfusion, so that the physiological function of the renal pelvis is not damaged; meanwhile, the extra air enters the body, so that the heat dissipation in the laser treatment process is not facilitated, bacteria are easy to survive and propagate on the gas/liquid interface, infection is easy to occur, and the risk can be effectively avoided due to the closable design scheme of the secondary channel 3.
Example 2
The present embodiment proposes a medical sheath, which is different from the first embodiment only in that the secondary channel part adopts a long thin-walled tube shape different from the long thin-walled tube shape of the long thin-sheet channel part 35, that is, the secondary channel 3 is formed by sleeving or sleeving the long thin-walled tube-shaped channel part 36 with the sheath body 1, the connection part 32 is formed at the connection part of the long thin-walled tube-shaped channel part 36 and the tube wall of the sheath body 1, and the free part 31 is formed at the rest part of the long thin-walled tube-shaped channel part 36. The arrangement form of the long sheet passage members 35 can be changed by changing the number and arrangement positions of the long sheet passage members 35 to change the arrangement number and arrangement form of the secondary passages 3 on the sheath main body 1, and it is possible to realize only partial arrangement of the secondary passages 3 on the sheath main body 1. The long thin-wall tubular channel member 36 is different from the sheath tube main body 1, and the whole of the long thin-wall tubular channel member 36 can be sleeved outside the sheath tube main body 1 or inside the sheath tube main body 1, and the annular cavity between the long thin-wall tubular channel member 36 and the sheath tube main body 1 can be integrally used as the secondary channel 3, or the whole annular cavity can be divided into a plurality of mutually independent secondary channels 3 by connecting part of the long thin-wall tubular channel member 36 with the wall of the sheath tube main body 1 to form the connecting part 32. The plurality of secondary channels 3 formed are preferably each arranged parallel to the axial direction of the sheath body 1.
The arrangement of the connecting portion 32 between the long thin-walled tubular passage member 36 and the sheath body 1, the arrangement of the passage outlet 34, the arrangement of the passage inlet 33, and the like are all in communication with the first embodiment, and detailed description thereof will be omitted.
In this embodiment, the long thin-walled tubular channel member 36 may also be integrally formed with the sheath body 1, such as co-extrusion, so that the application field and practical application effect of the medical sheath are the same as those of the first embodiment, and detailed descriptions thereof are omitted herein.
Example 3
The present embodiment proposes a medical sheath, which is different from the first embodiment only in that the secondary channel part adopts a thin-wall fire-fighting water band shape different from the long sheet channel part 35, that is, the secondary channel 3 is formed by connecting at least one thin-wall fire-fighting water band-shaped channel part 37 with the tube wall of the sheath body 1, and the thin-wall fire-fighting water band-shaped channel part 37 is a soft tube structure, which can be expanded when fluid or an instrument is introduced, and is in a collapsed closed state after the fluid or the instrument is discharged. In this scheme, the junction of the thin-wall fire-fighting water band-shaped channel part 37 and the sheath main body 1 forms a connecting part 32, the wall of the thin-wall fire-fighting water band-shaped channel part 37 forms a free part 31, and the inner pipeline of the thin-wall fire-fighting water band-shaped channel part 37 is exactly the secondary channel 3. The thin-walled fire-fighting water band channel members 37 may be uniformly distributed in the circumferential direction of the sheath body 1, or may be arranged only locally in the sheath body 1, as in the long sheet channel members 35.
In this embodiment, the connection portion 32 between the thin-wall fire-fighting water band-shaped channel member 37 and the sheath tube main body 1, the channel outlet 34 and the channel inlet 33 are all in communication with the first embodiment, and detailed description thereof will be omitted.
In this embodiment, the thin-wall fire-fighting water band-shaped channel member 37 may also be integrally formed with the sheath body 1, such as co-extrusion, so that the application field and practical application effect of the medical sheath are the same as those of the first embodiment, and detailed descriptions thereof are omitted herein.
Example 4
The present embodiment proposes a medical sheath, which differs from the first embodiment only in that the secondary channel 3 is constituted by a thin-walled protruding portion co-extruded with the sheath body 1, i.e. the secondary channel 3 is integrally formed with the sheath body 1. The extruded thin-walled protruding portion serves as a free portion 31, which protrudes into or out of the lumen of the sheath body 1. When the thin-wall protruding part is detected into the cavity of the sheath tube main body 1 in the initial state and the secondary channel 3 is in an open state, the thin-wall protruding part can be pressed by medical instruments or fluid entering the main channel 2 to deform, so that the thin-wall protruding part is attached to the inner wall of the main channel 2 connected with the thin-wall protruding part, and the secondary channel 3 is in a closed state and does not occupy the inner space of the main channel 2 and influence the ingress and egress of the medical instruments or fluid and the like in the main channel 2; when the thin-wall protruding part is detected to the outside of the cavity of the sheath tube main body 1 in the initial state and the secondary channel 3 is opened, and the sheath tube main body 1 enters a natural cavity channel of a human body and the like in use, the external thin-wall protruding part is pressed by the inner surface of the natural cavity channel to deform, so that the thin-wall protruding part is attached to the outer wall of the sheath tube main body 1 connected with the external thin-wall protruding part, and the secondary channel 3 is closed and does not enlarge the outer diameter size of the sheath tube main body 1. The secondary channel 3 is closed, and does not mean that the channel inlet 33 and the channel outlet 34 of the secondary channel 3 are closed to the outside communication state, but means that the internal space of the secondary channel 3 is eliminated, so that the internal space of the main channel 2 is not occupied or the outer diameter of the sheath body 1 is enlarged.
The secondary channels 3 may be provided in the same manner as the long sheet channel members 35, and may be uniformly distributed in the circumferential direction of the sheath body 1, or may be arranged only partially in the sheath body 1.
In this embodiment, the arrangement of the channel outlet 34 and the arrangement of the channel inlet 33 on the secondary channel 3 are all in communication with the first embodiment, and detailed description thereof will be omitted herein.
In this embodiment, the application field and the practical application effect of the medical sheath are the same as those of the first embodiment, and detailed descriptions thereof are omitted herein.
Example 5
In this embodiment, based on the medical sheath disclosed in any one of embodiments 1 to 4, one end, i.e., the distal end, of the sheath body 1 for extending into the body cavity is provided as a bendable section 12. The bendable section 12 can be bent passively under external pressure such as a physiological cavity or the like, or can be bent actively by an active steering knob or slider. In addition, in the medical sheath, a plurality of secondary channels 3 are generally uniformly distributed in the circumferential direction of the sheath body 1, even if the bendable section 12 at the distal end of the sheath body 1 is bent, the secondary channels 3 at the bending points are extruded, and part of the secondary channels 3 still exist at one side of the sheath body 1, which is far away from the bending direction, so that the normal function of perfusion fluid can be ensured.
The distal end of the medical sheath tube adopts a bendable design scheme, so that the problem that the traditional ureter guiding sheath cannot be bent to cause ureter injury is solved, the problem that the lavage liquid in operation is not smooth due to the fact that the sheath placement position is not in place can be avoided, and the efficiency and the safety of ureter surgery can be improved.
Example 6
The embodiment provides a ureteral guiding sheath 200, which comprises a joint 4 and a medical sheath tube as disclosed in any one of embodiments 1-4, wherein a guiding channel 41 is arranged on the joint 4, one end of the guiding channel 41 is sleeved at one axial end (namely a proximal end) of the sheath tube main body 1 through a tube connecting structure 42, and a buffer cavity 421 in sealing butt joint with a channel inlet 33 is arranged on the tube connecting structure 42; the joint 4 is further provided with a filling port 43 communicating with the buffer chamber 421 and a fluid discharge port 44 communicating with the main channel 2. The fluid discharge port 44 is also provided with a pressure regulating structure 45. The fluid outlet 44 is typically connected to a negative pressure device, and the pressure regulating structure 45 can regulate the magnitude of the negative pressure suction. The pressure adjusting structure 45 adopts a conventional pressure adjusting structure, such as a negative pressure valve, and the like, which will not be described herein.
In this embodiment, the buffer chamber 421 may serve as a fluid buffer. The buffer chambers 421 can be disposed in one-to-one correspondence with the secondary channels 3, and all the buffer chambers 421 are isolated from each other, and any buffer chamber 421 is correspondingly connected to a filling port 43. In addition to this form, the buffer chamber 421 may be provided as a continuous annular chamber channel arranged along the circumferential direction of the sheath body 1, with the channel inlet 33 of any one of the secondary channels 3 communicating with the buffer chamber 421. Only one filling port 43 is provided in the joint 4 and is in communication with the buffer chamber 421. The preferred buffer chamber 421 of this embodiment is a continuous annular channel, and by injecting fluid into the single injection port 43, all secondary channels 3 can be simultaneously injected, which is beneficial to improving the operation efficiency and the operation effect.
In this embodiment, the guide channel 41 is the main channel of the connector 4, and the filling port 43 and the fluid discharge port 44 are branch channels provided in the guide channel 41. Surgical instruments and the like used in surgery are generally introduced into the main channel 2 of the medical sheath through the guide channel 41. In the unused state, the end of the guide channel 41, which is far away from the pipe connecting structure 42, is provided with a sealing cap 46 for sealing, so that the dustproof effect is achieved.
When the ureter guiding sheath 200 is adopted for urinary surgery, the sheath body 1 is firstly placed into the renal pelvis 7, the matched endoscope or accessory enters the target position of the renal pelvis 7 through the main channel 2, the perfusion opening 43 is externally connected with perfusion liquid (the perfusion liquid can be injected into the perfusion opening 43 through perfusion equipment, manual work, natural gravity and the like), the fluid outlet 44 can be connected with external negative pressure equipment, and the pressure regulating structure 45 can regulate the pressure in the renal pelvis according to the requirement. When the broken stone reaches a certain degree, the endoscope is retracted to the near end of the main channel 2, a large enough space is reserved for attracting the broken stone, and the liquid can be poured into the channel inlet 33 through the pouring opening 43, so that the free part 31 of the secondary channel 3 is expanded by the water pressure to be in a spreading free state, and the requirement of balanced pouring quantity and backwater quantity in operation is met. Simultaneously, the liquid drives the crushed stone to be discharged out of the body through the main channel 2 and the fluid discharge port 44 in sequence. Since the space in the main channel 2 is not occupied, the reflux amount of the fluid in the sheath can be ensured.
Example 7
On the basis of embodiment 6, in the ureteral guiding sheath 200 proposed in this embodiment, one end, i.e., the distal end, of the sheath body 1 for extending into the human body lumen is provided as the bendable section 12. The bendable section 12 can be bent passively under external pressure such as a physiological cavity or the like, and can be bent actively by actively controlling the bending adjustment mechanism 5. In addition, in the medical sheath, a plurality of secondary channels 3 are generally uniformly distributed in the circumferential direction of the sheath body 1, and even if the bendable section 12 at the distal end of the sheath body 1 is bent, part of the secondary channels 3 still exist at one side of the sheath body 1 deviating from the bending direction to keep normal functions, so that the normal circulation of perfusion fluid can be ensured.
In this embodiment, the bending adjustment mechanism 5 may be disposed separately from the joint 4, or may be disposed directly on the joint 4. In order to promote integration, compactness and portability of the ureteral introducer sheath 200, it is preferred that the bending adjustment mechanism 5 is provided on the adapter 4 and on the wall of the guiding channel 41. The bending adjustment mechanism 5 comprises a haulage rope 51 and a haulage rope haulage mechanism, wherein the haulage rope 51 is arranged in the sheath body 1 in a penetrating way and is attached to the inner wall of the sheath body 1, and the haulage rope 51 does not influence the passage of fluid or instruments in the main channel 2. The traction rope 51 is preferably a soft metal wire, such as an iron wire, a copper wire, etc., one end of the traction rope 51 is connected with the bendable section 12, and the other end is connected with a traction rope traction mechanism, and the traction rope traction mechanism can regulate and control the bending degree of the bendable section 12 by pushing and pulling the traction rope 51 (can control the bendable section 12 to be bent into an arc with a central angle of 180-270 degrees, and can also control the bendable section 12 to be restored to a flat state). The traction rope traction mechanism can be a sliding block which is in sliding connection with the pipe wall of the guide channel 41, and the sliding block can slide along the axial direction of the guide channel 41 to linearly push and pull the traction rope 51; the traction rope traction mechanism can also be a knob rotationally connected with the pipe wall of the guide channel 41, and the traction rope 51 can be rolled and unrolled on the rotary shaft of the knob by rotating the knob, so that the effect of traction of the bendable section 12 is achieved. In practice, the bending direction and degree of bending of the bendable section 12 can be controlled by adjusting the number of the traction ropes 51 or the connection position of the traction ropes 51 and the bendable section 12.
The distal end of the medical sheath tube adopts a bendable design scheme, so that the problem that the traditional ureter guiding sheath cannot be bent to cause ureter injury is solved, the problem that the lavage liquid in operation is not smooth due to the fact that the sheath placement position is not in place can be avoided, and the efficiency and the safety of ureter surgery can be improved.
Example 8
This embodiment proposes a ureteral surgical system 100 comprising, as disclosed in embodiment 7, a ureteral introducer sheath 200, in addition to at least one of a perfusion apparatus (supplying perfusion fluid), an endoscope, a lithotripsy fiber, a long conical inner core 6, a negative pressure suction apparatus, and a guidewire 8. Wherein the long conical inner core 6 is generally sleeved in the main channel 2 of the medical sheath, and the front end (distal end) of the long conical inner core 6 is generally attached with a hydrophilic coating.
The ureteral operation system 100 includes a ureteral guide sheath 200, an endoscope (typically, a ureteroscope), a lithotripsy fiber, a long tapered inner core 6, a negative pressure suction device, and a guide wire 8 as disclosed in example 7, and a method of using the same will be specifically described. When the ureteral surgical system 100 is used, the steps are as follows:
step 1, as shown in fig. 31, a guide wire 8 is placed into the renal pelvis 7 using an associated medical instrument;
Step 2, as shown in fig. 32, inserting a guide wire 8 into the central hole of the guide sheath dilator, and inserting the guide ureter guide sheath 200 into the renal pelvis 7 along the guide wire 8 and reaching the target position;
step 3, as shown in fig. 33, the dilator is withdrawn, the negative pressure suction device is connected with the fluid discharge port 44, and the perfusion device is connected with the perfusion port 43;
step 4, opening the negative pressure suction equipment and the perfusion equipment;
step 5, introducing an endoscope and other auxiliary instruments into the main channel 2, and pushing the distal end of the sheath tube main body 1 in the ureter guiding sheath 200 to reach the calculus in an endoscope visual state; as shown in fig. 34, the bendable section 12 is bent during the arrival of the distal end of the sheath body 1 at the stone, which bending process can be assisted by the bending adjustment mechanism 5;
step 6, as shown in fig. 35, the lithotripsy optical fiber enters the renal pelvis 7 along the endoscope working channel to lithotripsy the target calculus, and the lithotripsy optical fiber is sequentially discharged outside the body through the sheath gap and the fluid outlet 44 under the suction of negative pressure;
step 7, as shown in fig. 36, when there is crushed stone which cannot be discharged from the sheath gap, the endoscope can be withdrawn to the tail end position of the joint 4, but the endoscope is not completely withdrawn, so that the front end of the endoscope is made to leave the communication port between the fluid discharge port 44 and the joint 4, and the crushed stone is prevented from being influenced to be discharged from the fluid discharge port 44;
And 8, completely withdrawing the endoscope from the guiding sheath after the broken stone is discharged, and adjusting the bending degree and the bending direction of the bendable section 12 by the bending adjusting mechanism 5 in an auxiliary way to realize the safe withdrawal of the sheath body 1 in the renal pelvis 7 in the ureter guiding sheath 200.
Therefore, the ureteral operation system 100 of the present embodiment can perform perfusion and suction simultaneously during the operation process, so as to greatly improve the operation efficiency and shorten the operation time.
It should be noted that it will be apparent to those skilled in the art that the present invention is not limited to the details of the above-described exemplary embodiments, but may be embodied in other specific forms without departing from the spirit or essential characteristics thereof. The present embodiments are therefore to be considered in all respects as illustrative and not restrictive, the scope of the invention being indicated by the appended claims rather than by the foregoing description, and all changes which come within the meaning and range of equivalency of the claims are therefore intended to be embraced therein.
The principles and embodiments of the present invention have been described in detail with reference to specific examples, which are provided to facilitate understanding of the method and core ideas of the present invention; also, it is within the scope of the present invention to be modified by those of ordinary skill in the art in light of the present teachings. In view of the foregoing, this description should not be construed as limiting the invention.

Claims (18)

1. A medical sheath comprising a sheath body (1), characterized in that the sheath body (1) has:
a main channel (2) which is arranged in the sheath tube main body (1) and is used for fluid or surgical instruments to pass through;
-a secondary channel (3) comprising a free portion (31) susceptible to deformation and a connecting portion (32) in contact with the sheath body (1), the secondary channel (3) having a channel inlet (33) and a channel outlet (34); when the initial state of the secondary channel (3) is a closed state, the free part (31) can be deformed by filling fluid or surgical instruments so as to open the secondary channel (3) to an open state; when the initial state of the secondary channel (3) is an open state, the free part (31) can be deformed by being pressed by external force so as to press the secondary channel (3) to a closed state.
2. Medical sheath according to claim 1, characterized in that the secondary channel (3) is formed by at least one long lamellar secondary channel part connected to the wall of the sheath body (1), the connection of the secondary channel part to the sheath body (1) forming the connection (32), the rest of the secondary channel part constituting the free part (31); the secondary channel (3) is provided with the channel inlet (33) at a position close to the axial first end of the sheath tube main body (1), and the secondary channel (3) is provided with the channel outlet (34) at a position close to the axial second end of the sheath tube main body (1).
3. Medical sheath according to claim 1, characterized in that the secondary channel (3) is formed by sleeving or sleeving a long thin-walled tubular secondary channel part in the sheath body (1), the connection part (32) is formed at the connection part of the secondary channel part and the tube wall of the sheath body (1), and the rest part of the secondary channel part forms the free part (31); the secondary channel (3) is provided with the channel inlet (33) at a position close to the axial first end of the sheath tube main body (1), and the secondary channel (3) is provided with the channel outlet (34) at a position close to the axial second end of the sheath tube main body (1).
4. Medical sheath according to claim 1, characterized in that the secondary channel (3) is formed by at least one thin-walled fire-hose-like secondary channel part connected to the wall of the sheath body (1), the connection of the secondary channel part to the sheath body (1) forming the connection (32), the wall of the secondary channel part constituting the free part (31); the secondary channel (3) is provided with the channel inlet (33) at a position close to the axial first end of the sheath tube main body (1), and the secondary channel (3) is provided with the channel outlet (34) at a position close to the axial second end of the sheath tube main body (1).
5. Medical sheath according to claim 1, characterized in that the secondary channel (3) consists of a thin-walled projection co-extruded with the sheath body (1), which, as the free portion (31), projects into or out of the lumen of the sheath body (1).
6. A medical sheath according to any one of claims 2 to 4, wherein the secondary channel member is integrally formed with the sheath body (1).
7. The medical sheath according to any one of claims 2 to 4, wherein the secondary channel member is folded over at an axial second end of the sheath body (1) to form a folded-over portion (38), the folded-over portion (38) wraps the axial second end of the sheath body (1) from both inner and outer sides, and the channel outlet (34) is opened in the folded-over portion (38).
8. The medical sheath according to claim 7, wherein the channel outlets (34) are distributed at least one of a first position, a second position and a third position of the turndown (38); the first position is located on a part of the turnover part (38) located on the outer wall of the sheath tube main body (1), the second position is located on a part of the turnover part (38) located on the inner wall of the sheath tube main body (1), and the third position is located at a turnover position of the turnover part (38).
9. The medical sheath according to any one of claims 2 to 5, wherein both ends of the secondary channel member extend to both axial ends of the sheath body (1), respectively, and are not longer than both axial ends of the sheath body (1).
10. The medical sheath according to any one of claims 2 to 4, wherein the connection portion (32) is constituted by a combination of one or more of a dot-shaped connection portion (321), a sheet-shaped connection portion (322), and a linear connection portion (323).
11. Medical sheath according to any one of claims 1-5, characterized in that the sheath body (1) is further provided with a temperature sensor and/or a pressure sensor.
12. Medical sheath according to any one of claims 1-5, characterized in that the sheath body (1) is provided with one of the secondary channels (3); alternatively, the sheath tube main body (1) is provided with a plurality of the secondary channels (3) along the circumferential direction thereof.
13. Medical sheath according to claim 12, characterized in that the end of the sheath body (1) for extending into the body lumen is provided as a bendable section (12).
14. The medical sheath of any one of claims 1-5, wherein the medical sheath is a vascular sheath, an airway sheath, a lacrimal sheath, an ear canal sheath, a digestive canal sheath, or a ureteral sheath.
15. A ureteral guiding sheath, characterized by comprising a joint (4) and the medical sheath tube according to any one of claims 1-12, wherein a guiding channel (41) is arranged on the joint (4), one end of the guiding channel (41) is sleeved on one axial end of the sheath tube main body (1) through a tube connecting structure (42), and a buffer cavity (421) which is in sealing connection with the channel inlet (33) is arranged on the tube connecting structure (42);
the joint (4) is also provided with a filling port (43) communicated with the buffer cavity (421) and a fluid discharge port (44) communicated with the main channel (2).
16. The ureteral guiding sheath according to claim 15, characterized in that the buffer cavities (421) are arranged in one-to-one correspondence with the secondary channels (3), all the buffer cavities (421) are mutually isolated, and any one of the buffer cavities (421) is correspondingly communicated with one of the perfusion ports (43);
alternatively, the buffer chamber (421) is a continuous annular channel circumferentially arranged along the sheath tube main body (1), and the channel inlet (33) of any secondary channel (3) is communicated with the buffer chamber (421).
17. Ureteral introducer sheath according to claim 15 or 16, characterized in that the end of the sheath body (1) facing away from the tube connection structure (42) is provided as a bendable section (12), the ureteral introducer sheath further comprising a bending adjustment mechanism (5) for controlling the degree of bending of the bendable section (12).
18. Ureteral surgical system, characterized by comprising a ureteral introducer sheath according to any of claims 15-17, further comprising at least one of a perfusion device, an endoscope, a lithotripsy fiber, a long conical inner core (6), a negative pressure suction device and a guide wire (8).
CN202311160258.3A 2023-09-08 2023-09-08 Medical sheath tube, ureter guiding sheath and ureter operation system Pending CN117138204A (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CN202311160258.3A CN117138204A (en) 2023-09-08 2023-09-08 Medical sheath tube, ureter guiding sheath and ureter operation system

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CN202311160258.3A CN117138204A (en) 2023-09-08 2023-09-08 Medical sheath tube, ureter guiding sheath and ureter operation system

Publications (1)

Publication Number Publication Date
CN117138204A true CN117138204A (en) 2023-12-01

Family

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Family Applications (1)

Application Number Title Priority Date Filing Date
CN202311160258.3A Pending CN117138204A (en) 2023-09-08 2023-09-08 Medical sheath tube, ureter guiding sheath and ureter operation system

Country Status (1)

Country Link
CN (1) CN117138204A (en)

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