CN209611446U - A kind of heat puncture support inserting device - Google Patents

Abstract

The utility model provides a kind of heat puncture support inserting device, support inserting device has proximally and distally, front hand grip distal end is equipped with outer tube, proximally extend to distal end, the outer diameter of distal outer tube is less than or equal to 3.15mm, it is equipped in insulation and manages in outer tube, conductive part is equipped in managing in insulation, pipe and conductive part proximally extend to distal end in insulation, conductive part proximal end can be connected with external power supply, boost tube is equipped in proximal outer tube and the insulation between pipe, the distal end of boost tube and the proximal end of pipe in the insulation are connected with each other, the distal end of conductive part is equipped with insulation division, conductive head is distributed on insulation division, conductive head is connect with conductive part realizes conducting function, conductive part is located in the space between conductive part distal end and outer tube after playing the role of the compression of supporting support bracket simultaneously.Front hand grip is connected with proximal outer tube, along boost tube recession front hand grip, drives the outer tube recession release bracket.

Description

A kind of heat puncture support inserting device

Technical field

The utility model relates to a kind of heat of medical instruments field to puncture device for posting, more particularly to a kind of cutting, injection The heat that function is integrated punctures support inserting device.

Technical background

Alimentary canal gall-bladder anastomosis, hot device for posting enters target through stomach wall or duodenal wall puncture exactly under scope In the gall-bladder of position, the distal end of the double mushroom head brackets of full overlay film is placed in gall-bladder, the proximal end of mushroom head is placed on stomach or 12 In duodenum 12, to get through the channel between alimentary canal and gall-bladder, that is, a new road between alimentary canal and gall-bladder has been made again. Again by gastroscope and the channel built up again, the calculus in gall-bladder is taken out using stone extraction basket, to protect gallbladder under realizing scope Shi Shoushu is taken, provides a kind of new therapeutic problem to be not suitable for the gallbladder disease patient of operation, it also can be good for gallbladder function Patient provide it is a kind of retain gallbladder function treatment method, improve long-term life quality of patients.Stomach Pancreatic Psoudocyst branch Frame anastomosis operation punctures through stomach under scope and enters in patient's Pancreatic Psoudocyst, places the double mushroom heads of the full overlay film of diameter at a gulp Bracket realizes coincideing for stomach and Pancreatic Psoudocyst, to sufficiently be drawn to hydrops in Pancreatic Psoudocyst and sphacelus Stream.

Duodenum anastomosis of bile ducts, traditional ERCP operation are driven in the wrong direction from duodenum by seal wire by ERCP scope Equal instruments insertion duodenofiberscope reaches choledochus, carries out taking stone biopsy treatment etc. to choledochus.For the insertion of seal wire difficulty Patient usually wants percutaneous puncture or carries out surgical operation, may be decreased patients ' life quality or bring bigger wound.

Gastroenterostomy, by tumor invading, the channel that food enters enteron aisle in stomach be blocked the patient that after death, keeps vomiting with It is past or receive abdominal, establish stomach and intestine new tunnel or can only be supported by intravenous nutrition.And it is bigger than normal for those ages or For person's physical condition for unsuitable progress abdominal patient, life quality is extremely low, also brings heavy burden to family. Gastroenterostomy enters in proximal small bowel exactly under scope through stomach puncture, places the double mushroom head branch of the full overlay film of diameter at a gulp Frame to get through the channel between stomach and small intestine, that is, has made a new road between stomach and small intestine again, to solve 12 Duodenum 12 is blocked to be influenced to minimal invasive treatment's bring.

Previous such " bypass " builds the abdominal that need to apply general anaesthetic, and wound is larger.And endoscopic Minimally Invasive Surgery wound Hurt small, operating time is short, and pain is small, restores fast, has fully demonstrated the minimally invasive advantage of scope.In recent years, with endoscopic technic with And the continuous development and update of various instrument accessories, scope have played more and more heavy on the various disease treatments of digestive system The effect wanted, especially endoscopic minimally-invasive treatment operation are constantly brought forth new ideas, for the gastrointestinal tract and gallbladder that much cannot or be reluctant operation The patient of pancreas disease provides new Minimal invasive procedures.Above four traditional operations, bracket general diameter are at presentDouble mushroom head metallic supports, matched hot device for posting outer diameter are(10.5Fr~ 10.8Fr), traditional endoscopic ultrasonography clamps roadBecause gap is too small, tradition electrification device for posting in endoscopic forceps channel back and forth Very not freely, this is the main reason for difficulty is carried out in the above operation for movement.The outer diameter of endoscopic ultrasonography simultaneouslyThan tradition Gastroscope outer diameterBig 4mm, it is more inconvenient to operate, can reach it is local also relatively less.

Therefore, stomach gallbladder anastomosis, gastroenterostomy and through human body natural's cavity scope are carried out by gastroscope in order to realize Perform the operation (NOTES) etc., needs to design smaller electrification device for posting, clamps road by gastroscope, simplifies bracket release steps, more to pacify Bracket is more efficiently discharged entirely, and the utility model provides a kind of mode of completely new solution obstruction of bile duct, while having saved hand The art time saves surgical instrument, reduces operating difficulty, carries out this operation for more doctors and provide possibility.

Utility model content

The heat of the utility model punctures support inserting device, traditional device for posting inner tube and conductive filament is eliminated, by conductive part Part replaces, and has both played supporting support purpose simultaneously but also with transmission high frequency Electricity Functional.Existing heat can be punctured the outer of device for posting Diameter is reduced to 3.15mm (9.5Fr) by 3.5mm~3.6mm (10.5Fr~10.8Fr), so that heat is punctured device for posting and is crossed and passes through biography The gastroscope of system clamps roadThe alimentary canal gall-bladder anastomosis in more forward position, duodenum anastomosis of bile ducts, stomach pancreas are done for doctor Gland false cyst bracket anastomosis operation, gastroenterostomy and NOTES operation etc. provide possibility.

Hereinafter, one end of conductive head is defined as distal end, the one end for putting into the external energization of device is defined as proximal end.

Heat, which punctures support inserting device, to be had proximally and distally, and front hand grip distal end is equipped with outer tube, and outer tube is proximally to distally prolonging It stretches, the outer diameter of the distal outer tube is less than or equal to 3.15mm, is equipped in insulation and manages in the outer tube, proximally to distally prolonging It stretches, pipe is interior in the insulation is equipped with conductive part, and pipe and conductive part are proximally to distally extension, the conductive part proximal end end in insulation End can be connected with external power supply；In the proximal outer tube and the insulation between pipe be equipped with boost tube, the boost tube it is remote End and the proximal end of pipe in the insulation are connected with each other；Insulation division is located at the distal end of the conductive part, and the distal end of conductive part is equipped with exhausted Conductive head is distributed on insulation division for edge, and conductive head is connect with conductive part realizes conducting function, is located at conductive part after bracket compression In space between distal end and outer tube, front hand grip is connected with proximal outer tube, along boost tube recession front hand grip, drives the outer tube Recession release bracket.Conductive part both plays the role of electric action, while playing supporting support, compared with conventional stent implanting device, Reduce inner tube and seal wire, while electrically conductive, tissue is cut, discharges bracket after reaching lesions position.

There is certain gap between insulation division and conductive part, there is conductive head, conductive head in the distal tip of device for posting One end can be from distally proximally extending into the gap between the insulation division and the conductive part, to connect with conductive part Realization conducting function is connect, the other end of conductive head is overlying on the outer surface of insulation division.

Preferably, conductive part is hollow conductive part.

It is highly preferred that the proximal end of conductive part is connected with female Luer realizes fluid injection.

Preferably, conductive part is conductive filament.

Preferably, conductive part is titanium-nickel wire

Preferably, conductive part is metal material.It is highly preferred that conductive part is stainless steel material.

Preferably, the material of insulation division is ceramics.

Outer tube includes proximal end outer tube and distal end outer tube, and the proximal end outer tube is connected with distal end outer tube using taper.Boost tube Proximally extend and be connected with back handle, positioning region is equipped between the front hand grip and back handle.Apart from the conductive head one On the outer surface of the conductive part of set a distance, it is covered with resistance part.Conductive head is made of two or four conductive filaments, and two or four are led Electrical filament is evenly distributed in the slot of insulation division outer surface.Conductive head is overlying on the appearance of insulation division close to the other end in outside completely Face, when being cut with the conductive head, wound cut surface is rounded face.The outer surface of conductive part can be covered with riveted pipe, institute The one end for stating conductive head can pass through institute from the gap between the insulation division and the conductive part is distally proximally extended into It states riveted pipe and connect realization conducting function with the conductive part.

The utility model has the advantages that

The outer diameter that the utility model heat punctures bracket is less than the outer diameter of support inserting device in the prior art, much cannot Or it is reluctant that the gastrointestinal tract of operation and the patient of Bile-pancreatic diseases provide new Minimal invasive procedures.

The heat of the utility model punctures device for posting can be by diameterDouble mushroom head titanium-nickel wire braiding gold Belong to bracket to be packed into wherein, road 3.2mm is clamped by traditional gastroscope and enters stomach, the organs such as duodenum, device for posting, which is powered, punctures stomach wall Or intestinal wall, into small intestine, gall-bladder, pancreatic cyst in the structures such as choledochus, carries out bracket and accurately discharges, will can organize above It coincide respectively with stomach wall or intestinal wall, realizes drainage, protect gallbladder, take stone, open the functions such as bypass.

Detailed description of the invention

Figure 1A is device for posting diagrammatic cross-section

Figure 1B is device for posting section distal structure schematic diagram

Fig. 2 is device for posting product overall schematic

Fig. 3 A is the B-B diagrammatic cross-section of Figure 1B when conductive part is hollow conductive part

Fig. 3 B is the C-C diagrammatic cross-section of Figure 1B when conductive part is hollow conductive part

Fig. 4 A is the B-B diagrammatic cross-section of Figure 1B when conductive part is conductive filament

Fig. 4 B is the C-C diagrammatic cross-section of Figure 1B when conductive part is conductive filament

Fig. 5 A is the proximal end tail structure sectional view of support inserting device corresponding with Fig. 3 A and 3B

Fig. 5 B is the partial enlarged view of 5A

Fig. 6 is the proximal end tail structure sectional view of support inserting device corresponding with Fig. 4 A and 4B

Fig. 7 A-7D is different types of device for posting distal end schematic diagram

Fig. 8 A-8B is the device for posting distal end schematic diagram of integral type

Fig. 9 A-9B is split type device for posting distal end schematic diagram

Figure 10 A-10C is the device for posting distal end schematic diagram of flanging type

Figure 11 is safe block button schematic diagram

Figure 12 is that double mushroom brackets fully open schematic diagram

11, conductive head, 12, insulation division, 13, conductive part, 21, outer tube, 211, proximal end outer tube, 212, distal end outer tube, 22, help Ejector sleeve, 23, insulation in manage, 24, safe block button, 25, the tight lock nut of outer tube, 26, safety lock, 27, positioning region, 28, resistance part, 29, Riveted pipe, 30, front hand grip, 31, back handle, 32, conductive seat, 33, conductive plug, 34, female Luer, 40, remote organization, 41, Proximal tissue, 42, double mushroom head brackets

Specific embodiment

In order to make the purpose of the utility model, technical solutions and advantages more clearly understood, below in conjunction with attached drawing and implementation Example, the present invention will be further described in detail.It should be appreciated that specific embodiment described herein is only to explain this Utility model is not used to limit the utility model.

Hereinafter, one end of conductive head is defined as distal end, one end of the external energization of support inserting device is defined as proximal end.

As shown in Figure 1A, 1B and Fig. 2, the support inserting device of the utility model has proximally and distally, support inserting device packet Include outer tube 21, boost tube 22, pipe 23 in insulation, the tight lock nut 25 of outer tube, safety lock 26, positioning region 27, resistance part 28, front hand grip 30, back handle 31, conductive seat 32, conductive plug 33, female Luer 34, conductive head 11, insulation division 12, conductive part 13.

Outer tube 21 includes proximal end outer tube 211 and distal end outer tube 212, and the big setting of outer tube 211 in proximal end, can in 30 distal end of front hand grip Fixed with front hand grip 30 by the tight lock nut of outer tube 25,30 proximal end of front hand grip is equipped with safety lock 26, and safety lock 26 has screw thread, can be with 30 proximal threads Matching installation of front hand grip.Pipe 23 and bracket in insulation are equipped in outer tube 21, pipe 23 in mount proximal end and insulation Distal end mutually abuts, and rack far end and insulation division 12 are close, and there are certain gap, proximal end outer tube 211 is adopted with distal end outer tube 212 It being connected with taper, is equipped with boost tube 22 in proximal end outer tube 211 and insulation between pipe 23, boost tube 22 can be stainless steel material, The distal end of boost tube 22 and the proximal end of pipe 23 in insulation are connected with each other, the taper design of proximal end outer tube 211 and distal end outer tube 212, So that into lesions position distal end outer tube 212 size be less than or equal to 3.15mm, and proximal end outer tube 211 and insulation in pipe 23 Between be equipped with boost tube 22, thus provide release bracket needed for power.Pipe 23 can be by special high molecular material polyethers in insulation Ether ketone is made, electrically insulative with high performance, the high-frequency electrical of conductive part 13 and boost tube 22 can be dielectrically separated from, make to operate Person avoids electric shock risk completely.Boost tube 22 proximally extends to be connected with back handle 31, is equipped with and is led in the proximal end of back handle 31 Electric seat 32, conductive seat 32 is interior to have conductive plug 33, and conductive plug 33 can be connected by conductive part 13 with conductive head 11, To realize energization.

Positioning region 27 is also provided between front hand grip 30 and back handle 31, positioning region 27 can be designed to safety card Button 24 structure, as shown in figure 11, positioning region 27 be 24 structure of safe block button, discharge bracket when, first unscrew safety lock 26, will before Handle 30 is proximally dropped back, and safe block button 24 is encountered, and rack far end discharges in remote organization 40, withdraws support inserting device, will Bracket lifts in the proximal tissue, removes safe block button 24, continues front hand grip 30 of proximally dropping back, in proximal tissue 41 after Continuous release bracket connects to realize that remote organization 40 and proximal tissue 41 coincide by bracket.

On the outer surface of the conductive part 13 apart from 11 certain distance of conductive head, it can be covered with resistance part 28, resistance part 28 exists When bracket discharges, the resistance that bracket can be given certain, so that bracket difficultly slips off outside lesion.

The distal end of support inserting device further includes conductive head 11, insulation division 12, conductive part 13.When the external high frequency of conductive plug 33 After power supply, high frequency electric source is transmitted at conductive head 11 by conductive part 13, so that support inserting device has the function of cutting, to people Body tissue carries out high frequency cutting.Conductive part 13 can be the medical metal material of any kind, such as niti material or stainless Steel material；Conductive part 13 is set in insulation in pipe 23, from proximal end is distally extended to, is connected by back handle 31 with conductive plug 33 It connects, the outer diameter of conductive part 13 can be designed according to actual needs, the utility model can be incited somebody to action by the design of conductive part 13 The outer diameter for the merging part that existing heat punctures support inserting device is reduced to by 3.5mm~3.6mm (10.5Fr~10.8Fr) 3.2mm (9Fr) is hereinafter, preferably can reduce 3.15mm (9.5Fr).In addition, conductive part 13 can be hollow conductive part, from And realize fluid injection developing function, conductive part 13 can also be designed to conductive filament.When conductive part 13 is designed to hollow conductive part, figure Cross-sectional view at the position B-B of 1B is as shown in Figure 3A, it is shown that conductive part 13, the position of pipe 23 and distal end outer tube 212 in insulation Relationship, the cross-sectional view at the position C-C of Figure 1B are as shown in Figure 3B, it is shown that conductive part 13, pipe 23 and proximal end outer tube 212 in insulation Positional relationship；Fig. 5 A is the proximal end tail structure sectional view of support inserting device corresponding with Fig. 3 A and 3B, and Fig. 5 B is for 5A Partial enlarged view, there is conductive plug 33, conductive plug 33 can pass through conductive part 13 and 11 phase of conductive head in conductive seat 32 Connection, to realize energization；The proximal end of conductive part 13 is connected with female Luer 34, and doctor can be connected by standard impregnator Female Luer 34 is connect, and can pass through the lumen of conductive part 13 to hollow pipe cavity liquid injecting or contrast agent, liquid contrast agent, arrive Up at the distal end conductive head 11 of device for posting, and then patient's lesions position is injected, contrast agent develops under X-ray, indicates for doctor Lesion target position, doctor can be ready for the release of next step bracket.

When conductive part 13 is designed to conductive filament, conductive filament can use different sizes according to demand.The position B-B of Figure 1B The cross-sectional view for setting place is as shown in Figure 4 A, it is shown that conductive part 13, the positional relationship of pipe 23 and distal end outer tube 212, Figure 1B in insulation The position C-C at cross-sectional view it is as shown in Figure 4 B, it is shown that conductive part 13, the position of pipe 23 and proximal end outer tube 212 in insulation Relationship；Fig. 6 is the proximal end tail structure sectional view of support inserting device corresponding with Fig. 4 A and 4B, has conductive insert in conductive seat 32 First 33, conductive plug 33 can be connected by conductive part 13 with conductive head 11, to realize energization.

Insulation division 12 is located at the distal end of conductive part 13, has certain gap between insulation division 12 and conductive part 13, conductive First 11 one end can be from the gap between insulation division 12 and conductive part 13 be distally proximally extended into, thus with conductive part 13 Connection realizes that conducting function, the other end of conductive head 11 are overlying on the outer surface of insulation division 12.High-frequency electrical is transmitted by conductive part 13 To at the distal end conductive head 11 of support inserting device, make support inserting device that there is electric cutting function, tissue can be carried out high Frequency cuts and punctures, and insulation division 12 can be made of the materials such as ceramics, and tissue can be prevented glutinous viscous, make cutting more easily into Row.

The utility model conductive part 13 has conducting function instead of the inner tube and conductive filament of conventional stent device for posting, will Originally inner tube outside diameterWith conductive filament outer diameterDiameter is substituted for be less thanConductive part 13, always Diameter reducesSpace (space for reducing 3Fr), fill Conventional coverlay film gastrointestinal stent (10mm~16mm) can Enter, and by original traditional hot device for posting outer diameter(10.5Fr~10.8Fr) is reduced to 3.15mm (9.5Fr), enables electric device for posting to pass throughGastroscope clamps road.

The structure of the conductive head 11 of the support inserting device distal end of the utility model, insulation division 12 and conductive part 13 can be as Shown in Fig. 7 A-7D, conductive head 11 can be made of two or four conductive filaments, and one end can be from distally proximally extending into Conducting function, the other end of conductive head 11 are realized to connect with conductive part 13 in gap between insulation division 12 and conductive part 13 It is overlying on the outer surface of insulation division 12.Conductive head 11 can also be evenly distributed on insulation division in distal end with two or four conductive filaments In the slot of 12 outer surfaces, conductive cutting function is realized.Adjacent conductive silk interval angles are identical in the outer surface slot of insulation division 12, The radial radial distribution on the outer surface of insulation division 12.

As shown in figures 8 a-8b, one end of conductive head 11 can be from distally proximally extending into insulation division 12 and conductive part Gap between 13 realizes that conducting function, the other end of conductive head 11 are overlying on insulation division 12 completely to connect with conductive part 13 Outer surface.When being cut at this time with conductive head 11, cut surface is rounded face, rather than a straight type notch, is stopped utilizing It is easier to stop blooding when blood pinching blood, is conducive to wound healing.

As shown in figs. 9 a-9b, the outer surface of conductive part 13 can be covered with riveted pipe 29, and one end of conductive head 11 can be from remote End proximally extends into the gap between insulation division 12 and conductive part 13, connect realization with conductive part 13 by riveted pipe 29 and leads Stainless steel material can be used in Electricity Functional, riveted pipe 29, can connect conductive part 13 and insulation division 12.As shown in Fig. 9 A, lead The other end of dateline 11 can be overlying on the outer surface of insulation division 12 completely, and when being cut at this time with conductive head 11, cut surface is Rounded face, rather than straight type notch, are conducive to wound healing.

As shown in figures 10a-10c, the other end of conductive head 11 can be with the formal distribution of a conductive filament in insulation division 12 In the slot on surface, and in the distal tip pitch of the laps of support inserting device, a word inclined-plane conduction notch is formed, when cutting tissue at this time, What is utilized is the conductive filament of pitch of the laps and the conductive filament that is distributed in slot.If without riveted pipe 29, the conductive head 11 and conduction of one end Portion 13 is connected directly, and other end conductive head 11 can also realize conducting function in 12 peripheral distribution of insulation division.

When in use, after the external high frequency electric source of conductive plug 33, high frequency electric source is logical for the stenter to implant device of the utility model Conductive part 13 is crossed to be transmitted at conductive head 11, it, can remote organization 40 to lesion so that support inserting device has the function of cutting It is cut, if conductive part 13 is hollow conductive part, external female Luer, so that support inserting device has liquid injecting function.

As shown in figure 12, support inserting device is punctured by heat and discharges double mushroom head brackets 42, when double mushroom head brackets 42 are beaten After opening, one end is in remote organization 40, and the other end is in proximal tissue 41.

It is only the preferred embodiment of the application described in upper, makes skilled artisans appreciate that or realizing the application's Utility model.A variety of modifications and combination for these embodiments will be apparent for those skilled in the art , the general principles defined herein can without departing from the spirit or scope of the application, in other embodiments Middle realization.Therefore, the application will not be limited in the embodiments shown herein, and be to fit to it is disclosed herein Principle and the consistent widest scope of features of novelty.

Claims (15)

1. a kind of heat punctures support inserting device, which is characterized in that the heat, which punctures support inserting device, to be had proximally and distally, remote holder Handle distal end is equipped with outer tube, and the outer tube proximally extends to distal end, and the outer diameter of the distal outer tube is less than or equal to 3.15mm, institute It states to be equipped in insulation in outer tube and manage, manage in the insulation and proximally extend to distal end, be equipped with conductive part in insulation in pipe, it is described to lead Electric portion proximally extends to distal end, and the conductive part proximal end can be connected with external power supply；The proximal outer tube and described Boost tube is equipped in insulation between pipe, the distal end of the boost tube and the proximal end of pipe in insulation are connected with each other；The conductive part Distal end is equipped with insulation division, and conductive head is distributed on insulation division, and the conductive head is connect with conductive part realizes conducting function, conductive part Play the role of supporting support simultaneously, is located in the space between conductive part distal end and outer tube after bracket compression, front hand grip and outer tube Proximal end is connected, and along boost tube recession front hand grip, drives the outer tube recession release bracket.

2. heat according to claim 1 punctures support inserting device, which is characterized in that the insulation division and the conductive part it Between there is certain gap, there is conductive head in the distal tip of device for posting, one end of the conductive head can be from distal end to close End extends into the gap between the insulation division and the conductive part, realizes conducting function to connect with conductive part, described The other end of conductive head is overlying on the outer surface of insulation division.

3. heat according to claim 1 punctures support inserting device, which is characterized in that the conductive part is that hollow tubular is conductive Portion.

4. heat according to claim 3 punctures support inserting device, which is characterized in that the proximal end of the conductive part and Shandong Your connector, which is connected, realizes fluid injection.

5. heat according to claim 1 punctures support inserting device, which is characterized in that the conductive part is conductive filament.

6. heat according to claim 1 punctures support inserting device, which is characterized in that the conductive part is titanium-nickel wire.

7. heat according to claim 1 punctures support inserting device, which is characterized in that the conductive part is metal material.

8. heat according to claim 7 punctures support inserting device, which is characterized in that the conductive part is stainless steel material.

9. heat according to claim 1 punctures support inserting device, which is characterized in that the outer tube includes proximal end outer tube and remote Outer tube, the proximal end outer tube and distal end outer tube is held to connect using taper.

10. it is according to claim 1 heat puncture support inserting device, which is characterized in that the boost tube proximally extends and Back handle is connected, and positioning region is equipped between the front hand grip and back handle.

11. heat according to claim 1 punctures support inserting device, which is characterized in that apart from one spacing of conductive head From conductive part outer surface on, be covered with resistance part.

12. heat according to claim 1 punctures support inserting device, which is characterized in that the conductive head is by two or four Conductive filament is constituted, and two or four conductive filaments are evenly distributed in the slot of insulation division outer surface.

13. heat according to claim 1 punctures support inserting device, which is characterized in that the conductive head is close to the another of outside One end is overlying on the outer surface of insulation division completely, and when being cut with the conductive head, wound cut surface is rounded face.

14. heat according to claim 1 punctures support inserting device, which is characterized in that the outer surface of the conductive part can be with It is covered with riveted pipe, one end of the conductive head can be from distally proximally extending between the insulation division and the conductive part Gap, connect by the riveted pipe with the conductive part and realize conducting function.

15. heat according to claim 1 punctures support inserting device, which is characterized in that the material of the insulation division is ceramics.