CN210541659U

CN210541659U - Delivery sheath core for ureter soft lens stone extraction operation

Info

Publication number: CN210541659U
Application number: CN201920874628.2U
Authority: CN
Inventors: 邵怡; 方也
Original assignee: Shengwai Pharmaceutical Technology Shanghai Co Ltd
Current assignee: Shengwai Pharmaceutical Technology Shanghai Co Ltd
Priority date: 2019-06-12
Filing date: 2019-06-12
Publication date: 2020-05-19
Anticipated expiration: 2029-06-12

Abstract

The utility model belongs to the technical field of medical apparatus and instruments, and provides a delivery sheath core for a ureteroscope lithotomy, which comprises a sheath core front end and a sheath core rear end; the front end of the sheath core is a multi-cavity tube, and a main channel and an auxiliary channel are arranged in the multi-cavity tube; the rear end of the sheath core comprises an endoscope tube and a guide wire tube; the endoscope tube is horizontally connected with the tail end of the main channel of the multi-cavity tube and is used for placing the superfine endoscope; the guide wire tube is connected to the tail end of the auxiliary channel of the multi-cavity tube and used for penetrating the safety guide wire and inserting the safety guide wire into the corresponding auxiliary channel. The method has the advantages that the sheath can be fed under direct vision, the position of the guide sheath can be adjusted according to the calculus condition, the success rate and the safety of sheath feeding are greatly improved, the sheath feeding time and the sheath feeding times are reduced, the operation time is shortened, the operation efficiency is improved, and the ureter injury and complications are effectively avoided; meanwhile, the method is easy to industrially generate, and is beneficial to popularization of the ureter soft lens in hospitals at all levels in China.

Description

Delivery sheath core for ureter soft lens stone extraction operation

Technical Field

The application belongs to the technical field of medical instrument, especially, provides a soft lens of ureter gets stone operation with carrying sheath core.

Background

Urinary calculus is one of the most common diseases of the urinary system, has the incidence rate of about 8.8 percent in people, and has a rising trend. The early stage of the study participating in national urinary stone epidemiological survey shows that the nationwide population standardized prevalence rate is 6.06%, the population prevalence rate is 6.85% for men and 5.25% for women. Wherein the prevalence rate in Shanghai is 5.81%. Renal calculus and ureteral obstruction caused by ureteral calculus can cause hydronephrosis, damage kidney function, and finally cause renal fibrosis and renal atrophy.

At present, the means for treating the nephroureteral calculus mainly comprise external Shock Wave Lithotripsy (SWL), ureteroscope and ureteroscope (RIRS), percutaneous nephroscope (PCNL). The choice of the treatment method is mainly influenced by the position and the size of the calculus and whether the patient has excessive obesity, cardiovascular diseases and other factors. Although the curative effect of PCNL on treating kidney stones and ureteral upper segment stones is exact, the surgical channel needs to penetrate through the kidney parenchyma, the trauma to kidney tissues is large, and postoperative bleeding, pneumothorax, peripheral tissue injury and other complications are relatively more. The indications for ureteroscopy to facilitate access to individual renal calyces are expanding in the treatment of urinary system diseases. The Chinese urinary surgery disease diagnosis and treatment guidelines in 2014 indicate that the ureteric soft mirror can be well applied to patients with renal calculus complicated with anatomical or positional deformity of kidney such as renal calyx diverticulum calculus, polycystic kidney, renal rotation failure, repeated kidney, pelvic ectopic kidney, horseshoe kidney, medullary sponge kidney and the like, or SWL and PCNL which have poor curative effect usually cannot be applied to the patients. Gerighty R et al reported that over the last two decades, the volume of global ureteroscopy (including soft scope) surgery has escalated over time, while the proportion of percutaneous nephroscope surgery remains relatively constant. It can be seen that, with the continuous development of ureter soft lens technology and the pursuit of patients for operation comfort, ureter soft lenses are gradually becoming the first choice for doctors and patients to treat nephroureteral calculi.

In the soft ureteroscope operation, a soft ureteroscope conveying sheath is usually arranged to a collecting system under the guide of a guide wire, an inner core is drawn out and arranged in a soft ureteroscope, the pelvis, the upper calyx, the middle calyx and the lower calyx are probed in the sequence under the direct vision of the inner ureteroscope, and holmium laser fiber lithotripsy is arranged after finding out calculus. Whether the flexible ureteroscope conveying sheath can be successfully placed or not and whether the flexible ureteroscope conveying sheath can be placed in place or not directly influence the operation efficiency and the incidence rate of postoperative complications. At present, the mode of placing a flexible ureteroscope delivery sheath in China is mostly carried out under the guide of a guide wire, and although the success rate is high in general terms, the operation failure caused by the fact that the flexible ureteroscope delivery sheath cannot be inserted still exists; the operation difficulty is increased due to the fact that the flexible ureteroscope conveying sheath is not in place; the situation of postoperative infection and even septic shock is caused by the fact that the backflow is reduced in the operation, the visual field is unclear, the operation is interrupted, or the pressure of the renal pelvis is increased and exceeds a safety valve, so that bacteria in urine or in gravels are spread into blood. In addition, damage to the ureter, perforation of the ureter, tearing of the ureter and substantial damage to the kidney occur due to blind access to the sheath. While in foreign countries urinary surgeons often place flexible ureteroscope delivery sheaths under X-ray guidance, this approach, while increasing the success and safety of sheath access to some extent, presents the risk of exposing medical personnel and patients to X-rays.

Disclosure of Invention

The utility model aims to overcome prior art's not enough, provide a soft lens of ureter and get stone operation with carrying sheath core, can advance the guide sheath and confirm the position of guide sheath under looking directly to improve the success rate and the security of advancing the sheath, avoid ureter damage and complication's production, shorten operation time simultaneously.

In order to achieve the above object, the present application provides the following technical solutions:

a delivery sheath core for a ureter soft lens stone extraction operation comprises a sheath core front end and a sheath core rear end;

the front end of the sheath core is a multi-cavity tube, the front end of the multi-cavity tube is provided with a certain taper, and a main channel and an auxiliary channel are arranged in the multi-cavity tube; the rear end of the sheath core comprises an endoscope tube and a guide wire tube; the endoscope tube is horizontally connected with the tail end of the main channel of the multi-cavity tube and is used for placing the superfine endoscope; the guide wire tube is connected to the tail end of the auxiliary channel of the multi-cavity tube and used for penetrating the safety guide wire and inserting the safety guide wire into the corresponding auxiliary channel.

Further, the device also comprises a water injection pipe; meanwhile, another auxiliary channel is also arranged in the multi-cavity pipe and is used for connecting a water injection pipe so as to feed water;

or the guide wire tube is also communicated with the infusion tube to feed water.

Furthermore, the thread guide tube and the endoscope tube are arranged at a certain angle. In a preferred embodiment, the guidewire tube may be positioned at 30 ° to the endoscope tube.

Furthermore, the endoscope tube is connected with the main channel of the multi-cavity tube through a stainless steel tube.

Furthermore, the guide wire tube is connected with the auxiliary channel of the multi-cavity tube through a transition tube.

Furthermore, the superfine endoscope adopts an endoscope with the diameter of the endoscope body of 0.80mm, the angle of field of view of 90 degrees, the angle of field of view of 0-5 degrees, the number of pixels of 1 ten thousand and the working length of 40-80 cm.

Furthermore, the water injection pipe and the endoscope pipe are arranged in a certain angle in the axial direction, and the water injection pipe and the thread guide pipe are arranged in a certain angle in the radial direction. In a preferred embodiment, the water injection tube is arranged at 30 ° to the endoscope tube.

The application provides a soft lens of ureter is got stone operation and is used with carrying sheath core and superfine endoscope, guide sheath cooperation. Wherein, the superfine endoscope is arranged in the endoscope tube, the safety guide wire is inserted into the auxiliary channel of the multi-cavity tube through the guide wire tube, and the whole sheath core is inserted into the guide sheath through the front end of the sheath core. The superfine endoscope can be used for observing the internal condition of the ureter when entering the sheath after being connected with the light source, so that the sheath can be entered under direct vision, the angle and the direction can be adjusted according to the condition of the ureter, the success rate and the safety of the sheath entering are greatly improved, the sheath entering time and the sheath entering times are reduced, and the ureter damage and complications are effectively avoided.

Compared with the prior art, the beneficial effect of this application lies in: the method has the advantages that the sheath can be fed under direct vision, the angle and the direction can be adjusted according to the ureter condition, the success rate and the safety of sheath feeding are greatly improved, the sheath feeding time and the sheath feeding times are reduced, the operation time is shortened, the operation efficiency is improved, and the ureter injury and complications are effectively avoided; meanwhile, the method is easy to industrially generate, and is beneficial to popularization of the ureter soft lens in hospitals at all levels in China.

Drawings

FIG. 1 is a schematic view of a structure of a delivery sheath core for a ureter soft lens lithotomy provided by an embodiment of the application;

FIG. 2 is a cross-sectional view of another structure of a delivery sheath core for a soft ureteroscope lithotomy, which is provided by an embodiment of the application;

fig. 3 is a schematic view of a structure of an introducer sheath according to an embodiment of the present disclosure.

Description of the reference numerals

1 double-cavity tube, 2 endoscope tube, 3 guide wire tube, 4 transfusion tube, 5 stainless steel tube, 6 transition tube, 7 outer shell and 8 water injection tube;

10 guide sheath, 11 guide sheath joint.

Detailed Description

The technical solutions provided in the present application will be further described with reference to the following specific embodiments and accompanying drawings. The advantages and features of the present application will become more apparent in conjunction with the following description.

It should be noted that the embodiments of the present application have a better implementation and are not intended to limit the present application in any way. The technical features or combinations of technical features described in the embodiments of the present application should not be considered as being isolated, and they may be combined with each other to achieve a better technical effect. The scope of the preferred embodiments of this application may also include additional implementations, and this should be understood by those skilled in the art to which the embodiments of this application pertain.

Techniques, methods, and apparatus known to those of ordinary skill in the relevant art may not be discussed in detail but are intended to be part of the specification where appropriate. In all examples shown and discussed herein, any particular value should be construed as merely illustrative, and not limiting. Thus, other examples of the exemplary embodiments may have different values.

It is to be understood that the terms used herein are to be interpreted broadly and their specific meanings within the application can be specifically understood by those skilled in the art unless otherwise specifically defined or limited.

The drawings in the present application are in simplified form and are not to scale, but rather are provided for convenience and clarity in describing the embodiments of the present application and are not intended to limit the scope of the application. Any modification of the structure, change of the ratio or adjustment of the size of the structure should fall within the scope of the technical disclosure of the present application without affecting the effect and the purpose of the present application. And the same reference numerals appearing in the drawings of the present application denote the same features or components, which may be applied to different embodiments.

Example 1

As shown in fig. 1, the delivery sheath core for a ureteroscope lithotomy provided in this embodiment includes a front end of a sheath core placed in a body and a rear end of the sheath core placed outside the body. Wherein, the front end of the sheath core is a double-cavity tube 1, and a main channel and an auxiliary channel are arranged in the double-cavity tube 1; the rear end of the sheath core comprises an endoscope tube 2 and a guide wire tube 3; the endoscope tube 2 is horizontally connected with the tail end of the main channel of the double-cavity tube 1 and is used for placing an ultrafine endoscope; the guide wire tube 3 is connected with the tail end of the auxiliary channel of the double-cavity tube 1, and the safety guide wire is inserted into the auxiliary channel of the double-cavity tube 1 through the guide wire tube 3.

To facilitate insertion during surgery, the forward end of the dual lumen tube 1 is tapered, by way of example and not limitation, the taper of the forward end of the dual lumen tube 1 may be set at 20 ° or 25 °.

Furthermore, the thread guide tube 3 and the endoscope tube 2 can be arranged in a certain angle, so that the operation is convenient, the endoscope tube 2 and the thread guide tube 3 cannot collide with each other, and the mutual influence is avoided; and in a preferred embodiment, the guide wire tube 3 is arranged at 30 degrees to the endoscope tube 2, which can both avoid interference and facilitate the insertion of a safety guide wire.

Further, the endoscope tube 2 and the main channel of the double lumen tube 1 may be connected by a stainless steel tube 5 to provide a certain rigidity to facilitate the insertion of the ultra slim endoscope.

Further, the guide wire tube 3 and the auxiliary channel of the double-lumen tube 1 can be connected through a transition tube 6.

Furthermore, the guide wire tube 3 is communicated with the infusion tube 4 so as to facilitate water injection.

Furthermore, a shell 7 can be arranged at the rear end of the sheath core, and the endoscope tube 2 and the guide wire tube 3 are arranged in the protection of the shell 7 to avoid damage.

Furthermore, corresponding to the positions of the tail end of the endoscope tube 2, the tail end of the guide wire tube 3 and the infusion tube 4, holes are respectively formed in the shell 7 so as to facilitate the penetration of the superfine endoscope, the safe guide wire and the infusion tube 4.

In the application, the superfine endoscope can adopt an endoscope with the diameter of the endoscope body of 0.80mm, the angle of field of view of 90 degrees, the angle of field of view of 0-5 degrees, the number of pixels of 1 ten thousand and the working length of 40-80 cm.

Further, the diameter of the endoscope tube 2 may be designed to be 1.00mm for passing through an ultra-slim endoscope; the diameter of the guide wire tube 3 is designed to be 1.00mm for passing a safety guide wire.

The delivery sheath core for the ureteroscope lithotomy provided by the application is matched with an ultra-fine endoscope, a safety guide wire and a guide sheath 10 for use. Wherein, the superfine endoscope is arranged in an endoscope tube 2, the safety guide wire is inserted into the auxiliary channel of the double-cavity tube 1 through the guide wire tube 3, and the whole sheath core is inserted into the guide sheath 10 through the front end thereof. The structure of the introducer sheath 10 is shown in fig. 3, and the distal end thereof is connected to an introducer sheath connector 11. The superfine endoscope can be used for observing the internal condition of the ureter when entering the sheath after being connected with the camera system, so that the sheath can be entered under direct vision, the angle and the direction can be adjusted according to the condition of the ureter, the success rate and the safety of the sheath entering are greatly improved, the sheath entering time and the sheath entering times are reduced, and the ureter damage and complications are effectively avoided.

Example 2

As shown in fig. 2, the difference between the delivery sheath core for a ureteroscope lithotomy provided in this embodiment and embodiment 1 is that the front end of the sheath core is a three-lumen tube, and a main channel, a secondary channel and three channels are formed in the three-lumen tube; the rear end of the sheath core comprises a water injection pipe 8 besides the endoscope pipe 2 and the guide wire pipe 3; the endoscope tube 2 is horizontally connected with the tail end of the main channel of the three-cavity tube and is used for placing the superfine endoscope; the wire guide tube 3 is connected to the tail end of one auxiliary channel of the three-cavity tube, and the safe guide wire is inserted into the auxiliary channel through the wire guide tube 3; the water injection pipe 8 is connected to the tail end of the other auxiliary channel of the three-cavity pipe and used for water flowing.

Furthermore, the thread guide pipe 3 and the water injection pipe 8 are arranged at a certain angle with the endoscope pipe 2; in a preferred embodiment, the guidewire tube 3 and the water injection tube 8 may both be disposed at 30 ° to the endoscope tube 2.

Further, the guide wire tube 3 and the water injection tube 8 are also disposed at a certain angle in the radial direction so as not to interfere with each other in operation.

The delivery sheath core for the soft ureteroscope lithotomy provided by the application can improve the sheath entering success rate and safety of the soft ureteroscope delivery sheath and reduce the occurrence of ureter and kidney injury caused by blind sheath entering; the position of the sheath can be adjusted according to the condition of the junction of the ureter and the renal pelvis ureter by using the conveying sheath core sheath for the ureter soft-endoscope calculus removing operation, so that a better operation angle and perfusion liquid backflow can be obtained, the operation efficiency is greatly improved, the operation time is shortened, and the calculus can be broken in the phase I operation of some patients who originally need II-stage or even III-stage calculus; meanwhile, the clear visual field in the ureter soft lens operation is ensured through good perfusion liquid backflow, so that the situations of operation interruption and the like caused by the blurred visual field due to the intraoperative hemorrhage are reduced; therefore, the application of the delivery sheath core for the ureter soft-endoscope stone extraction operation shortens the treatment process of part of patients, practically reduces the economic burden of the patients in the hospitalization process, and also reduces the financial pressure of the state and the social medical insurance departments; meanwhile, due to the application of the conveying sheath core for the soft ureteroscope lithotomy operation, the occurrence of related complications of the soft ureteroscope operation is greatly reduced, particularly good backflow in the operation is avoided, the phenomenon that bacteria in urine or in gravels are scattered into blood due to the fact that the pressure of a renal pelvis is increased and exceeds a safety valve is avoided, and the incidence rate of postoperative infection, particularly uropyemia shock, is reduced; moreover, for patients with infection risk factors, the application of the delivery sheath core for the ureteroscope lithotomy can greatly reduce the huge economic burden of the part of patients possibly caused by uropyemia shock.

In addition, with the continuous expansion of the flexible ureteroscope operation indication, the market demand for flexible ureteroscope delivery sheath cores is further promoted. In consideration of operation safety and economic factors, the conveying sheath core for the ureteroscope lithotomy, which is developed and researched by the application and has independent intellectual property rights, has wide market application prospect, can reduce the economic burden of a patient in the treatment process, reduce the cost burden of a hospital, reduce the financial pressure of a national medical insurance department, and is consistent with the direction of national medical and health reform. Moreover, the delivery sheath core for the soft ureteroscope lithotomy, which is provided by the application, is easy to industrially generate, is beneficial to the popularization of the soft ureteroscope in hospitals at all levels in China, improves the international competitiveness of domestic middle and high-end medical equipment products, breaks through foreign price monopoly, assists 'China manufacture 2025', and has important significance and great social and economic benefits for improving the national health level.

Claims

1. A ureter soft lens stone operation is with carrying sheath core which characterized in that: comprises a sheath core front end and a sheath core rear end;

the front end of the sheath core is a multi-cavity tube, the front end of the multi-cavity tube is provided with a certain taper, and a main channel and an auxiliary channel are arranged in the multi-cavity tube; the rear end of the sheath core comprises an endoscope tube (2) and a guide wire tube (3); the endoscope tube (2) is horizontally connected with the tail end of the main channel of the multi-cavity tube and is used for placing the superfine endoscope; the guide wire tube (3) is connected with the tail end of the auxiliary channel of the multi-cavity tube and is used for penetrating the safety guide wire and inserting the safety guide wire into the corresponding auxiliary channel.

2. The delivery sheath core for the ureteroscope lithotomy according to claim 1, which is characterized in that: also comprises a water injection pipe (8); meanwhile, another auxiliary channel is also arranged in the multi-cavity pipe and is used for connecting a water injection pipe (8).

3. The delivery sheath core for the ureteroscope lithotomy according to claim 1, which is characterized in that: the guide wire tube (3) is also communicated with the infusion tube (4).

4. The delivery sheath core for the ureteroscope lithotomy according to any one of claims 1 to 3, wherein: the thread guide tube (3) and the endoscope tube (2) are arranged in a certain angle.

5. The delivery sheath core for the ureteroscope lithotomy according to claim 4, wherein: the thread guide tube (3) and the endoscope tube (2) are arranged in an angle of 30 degrees.

6. The delivery sheath core for the ureteroscope lithotomy according to any one of claims 1 to 3, wherein: the endoscope tube (2) is connected with the main channel of the multi-cavity tube through a stainless steel tube (5).

7. The delivery sheath core for the ureteroscope lithotomy according to any one of claims 1 to 3, wherein: the guide wire tube (3) is connected with the auxiliary channel of the multi-cavity tube through a transition tube (6).

8. The delivery sheath core for the ureteroscope lithotomy according to any one of claims 1 to 3, wherein: the superfine endoscope adopts an endoscope with the diameter of the endoscope body of 0.80mm, the angle of field of view of 90 degrees, the angle of field of view of 0-5 degrees, 1 ten thousand pixels and the working length of 40-80 cm.

9. The delivery sheath core for the ureteroscope lithotomy according to claim 2, wherein: the water injection pipe (8) and the endoscope pipe (2) are arranged at a certain angle in the axial direction, and the water injection pipe (8) and the thread guide pipe (3) are arranged at a certain angle in the radial direction.

10. The delivery sheath core for the ureteroscope lithotomy of claim 9, which is characterized in that: the water injection pipe (8) and the endoscope pipe (2) are arranged in an angle of 30 degrees.