CN211433155U

CN211433155U - Assembled circulation uninterrupted perfusion adjustable negative pressure stone removing sheath assembly

Info

Publication number: CN211433155U
Application number: CN201922209604.8U
Authority: CN
Inventors: 刘启明; 郑琴
Original assignee: Individual
Current assignee: Individual
Priority date: 2019-12-11
Filing date: 2019-12-11
Publication date: 2020-09-08
Anticipated expiration: 2029-12-11

Abstract

The utility model discloses an adjustable negative pressure stone removal sheath external member that assembled circulation was incessant to be filled. The utility model adopts an inner sheath main pipe, an inner sheath side hole, a middle section negative pressure suction sleeve, a negative pressure suction side hole, a negative pressure side branch, a negative pressure control through hole, a front section water inlet sleeve, a water inlet side hole, a water inlet side branch and a front section outer sheath; a double irrigation approach can be adopted; under the conditions of continuous perfusion and negative pressure suction, stone powder, pus, blood clots and the like can be quickly removed during stone breaking, and the visual field definition in the operation is improved; the stone can be prevented from flowing back and escaping under the negative pressure suction, the stone cleaning difficulty is reduced, and the bleeding risk when the stone is searched is reduced; continuous suction and simultaneous perfusion can form uninterrupted liquid circulation, the pressure condition in the cavity can be observed and adjusted at any time, the cavity is kept in a low-pressure state, the heating probability is reduced, and the operation safety is improved; when in lithotripsy, small stones are simultaneously sucked out under negative pressure, the stone removal rate is improved, and the operation time is reduced; reduce the consumption of equipment and the burden of patients.

Description

Assembled circulation uninterrupted perfusion adjustable negative pressure stone removing sheath assembly

Technical Field

The utility model relates to a clear stone device in urinary system calculus rubble operation, concretely relates to clear stone sheath external member of adjustable negative pressure of assembled incessant perfusion of circulation.

Background

Along with the change of dietary structure and life style of people, the incidence of urinary calculus also tends to rise year by year. From an open abdomen operation to noninvasive lithotripsy, various minimally invasive treatment modes such as open-surgery lithotripsy, extracorporeal shock wave lithotripsy, laparoscopic lithotripsy, pneumatic ballistic lithotripsy under ureteroscope, holmium laser lithotripsy technology, percutaneous nephroscope laser or EMS lithotripsy and the like appear in sequence. Currently, with the development of energy weapons for lithotripsy, particularly holmium laser, treatment of urinary calculus through natural channels or percutaneous renal channels has become a main treatment means, such as transurethral vesical calculus lithotripsy and stone extraction, transurethral ureteroscopic subtopical calculus lithotripsy and stone extraction through percutaneous renal channels. The holmium laser is used for carrying out lithotripsy treatment under a ureteroscope or a nephroscope, so that a remarkable clinical effect can be obtained. The holmium laser can make the calculus be vaporized into fine particles by means of "drilling effect" so as to naturally discharge the calculus out of the body. The holmium laser lithotripsy is particularly suitable for treating ureteral calculus, vesical calculus and intrarenal complex calculus. Currently, in urinary surgery, holmium laser is well accepted and favored by experts in urinary surgery, and is also the gold standard of urinary calculus.

Percutaneous nephrolithotripsy is a modern minimally invasive surgical technique in which a nephroscope is passed through a percutaneous renal passage (a passage that passes percutaneously into the calyx of the renal pelvis) to perform intracorporeal lithotripsy and stone extraction. At present, the urological department is mainly used for treating kidney stones larger than 2cm by percutaneous nephrolithotomy, and perfusion and suction are required to be combined while instruments are operated in the operation. The currently common percutaneous nephroscopy in clinic can be briefly divided into 4 types according to the size of a channel:

1. percutaneous nephrolithotomy (PCNL), conventional F20-24 channel, standard WOLF nephroscope or uretero nephroscope, lithotripsy apparatus with holmium laser or ballistic lithotripsy, or ultrasound negative pressure lithotripsy (EMS etc.),

2. minimally invasive percutaneous nephrolithotomy (mPCNL), conventional F16-18 channel, standard uretero-nephroscope, and lithotripsy equipment such as holmium laser or ballistic lithotripsy

3. Ultramicro percutaneous nephrolithotomy (Super-mini-PCNL, SMP), conventional F12-14 channel, SMP nephroscope, lithotripsy equipment using holmium laser.

4. Needle percutaneous nephrolithotomy (ultra mini-PCNL, UMP), conventional F11-13 channel, with UMP nephroscope, lithotripsy equipment using holmium laser.

However, in the existing methods for percutaneous renal duct fistulization, calculus removal and stone removal, PCNL and mPCNL use a single sheath, and perfusion and suction are performed discontinuously and alternately, so that the visual field is difficult to be ensured to be continuous and clear, time is required for waiting, and the calculus removal efficiency is influenced to a certain extent; in addition, the renal pelvis is over-pressurized during lithotripsy, and the renal pelvis is easy to be infected in a retrograde manner, so that complications such as sepsis, septicemia and the like are caused. Although the SMP nephroscope and the UMP nephroscope are designed with the independent sheath water inlet passage, the SMP nephroscope and the UMP nephroscope have the defects that an expensive matched nephroscope needs to be purchased additionally, the sheath of the passage is a metal sheath body, the postoperative renal passage cannot be provided with the balloon fistulation tube, once the passage has bleeding, the compression hemostasis is difficult, and the like.

In addition, all the nephroscopes, cystoscopes and the like clinically applied at present have the inherent defects that the stone removing efficiency is low, circulating water is difficult to form in the operation, the visual field is easy to blur in the process of crushing stones in the operation and the like when the cystoscopes, the cystoscopes and the like are used for treating the cystolith.

Disclosure of Invention

In order to solve the current shortcoming in the clear stone of rubble, the utility model provides an assembled circulation incessant adjustable negative pressure clear stone sheath external member that fills who uses in the clear stone art of percutaneous kidney passageway rubble or in the clear stone art of urethra bladder calculus rubble.

The utility model discloses an assembled endless adjustable negative pressure stone removing sheath subassembly that fills includes: the device comprises an inner sheath main pipeline, an inner sheath side hole, a middle-section negative pressure suction sleeve, a negative pressure suction side hole, a negative pressure side branch, a negative pressure control through hole, a front-section water inlet sleeve, a water inlet side hole, a water inlet side branch and a front-section sheath; wherein, the main pipe of the inner sheath is a straight pipe with hollow inside; a coaxial middle-section negative pressure suction sleeve is sleeved outside the inner sheath main pipe and positioned at the middle section, the middle-section negative pressure suction sleeve is cylindrical, and the inner diameter of the middle-section negative pressure suction sleeve is larger than the outer diameter of the inner sheath main pipe; an inner sheath side hole is formed in the side wall of the inner sheath main pipeline, and a negative pressure suction side hole is formed in the side wall of the middle-section negative pressure suction sleeve and in the position opposite to the inner sheath side hole; the negative pressure side branch is communicated to the inner sheath main pipeline through a negative pressure suction side hole and an inner sheath side hole; a negative pressure control through hole is formed in the side wall of the negative pressure side branch; a front-section water inlet sleeve which is hermetically connected and coaxial is arranged outside the main internal sheath pipeline and in front of the middle-section negative pressure suction sleeve, the inner diameter of the front-section water inlet sleeve is larger than the outer diameter of the main internal sheath pipeline, a water inlet side hole is formed in the side wall of the front-section water inlet sleeve, and a water inlet side branch is communicated to the front-section water inlet sleeve through the water inlet side hole; the front section sheath is spliced at the front end of the coaxial front section water inlet sleeve in a sealing way; the inner diameter of the front-section sheath is larger than the outer diameter of the inner sheath main pipe, and an annular water inlet channel is formed between the outer wall of the inner sheath main pipe and the inner walls of the front-section water inlet sleeve and the front-section sheath; the water inlet side branch is connected with a water inlet pipe, physiological saline is filled into the front-section water inlet sleeve from the water inlet side branch, flows forwards to the front end of the main inner sheath pipeline through a water inlet channel, and flows into the main inner sheath pipeline from the front end of the main inner sheath pipeline; the negative pressure side branch is connected with a negative pressure aspirator through a negative pressure pipe, and negative pressure is formed in the inner sheath main pipeline; the negative pressure control through hole is discontinuously pressed by the thumb to adjust the negative pressure.

The front section sheath adopts various matched tear-off sheaths with various types, and the tear-off sheath is an existing commercialized product; or a plurality of metal sheaths are adopted and assembled into a tubular shape. The front section sheath adopts the prior clinical common strippable sheath or a plurality of breakable metal sheaths, is flexibly mastered, does not change the conventional operation habit of the operator at present, does not increase the risk of accident occurrence after changing the operation mode, can use the fistulation tube with the air bag or the catheter after the operation is finished, and increases the channel safety. In order to achieve the purpose of splicing and sealing the front-section water inlet sleeve and the front-section sheath, the front end of the front-section water inlet sleeve is sleeved on the outer side wall of the tail end of the front-section sheath, and the inner diameter of the front-section water inlet sleeve is equal to the outer diameter of the front-section sheath, or the outer diameter of the front-section water inlet sleeve is equal to the inner diameter of the front-section sheath.

In order to realize the sealing between the front section water inlet sleeve and the middle section negative pressure suction sleeve, welding is adopted or a coaxial clapboard is arranged between the front section water inlet sleeve and the middle section negative pressure suction sleeve. Coaxial baffle setting is between the casing pipe is inhaled to the front segment water inlet and the middle section negative pressure suction sleeve pipe, and the baffle is the ring shape, and the plane perpendicular to inner sheath trunk line's axle that the baffle is located, and the internal diameter of baffle equals the external diameter of inner sheath trunk line for do not communicate between front segment water inlet sleeve pipe and the middle section negative pressure suction sleeve pipe.

The middle section negative pressure attracts sleeve pipe, baffle and anterior segment to intake sleeve pipe fixed connection together, if welding, bonding or threaded connection to it is airtight to realize that the middle section negative pressure attracts between sleeve pipe and the anterior segment casing pipe that intakes, prevents to leak.

The diameter of the inner sheath side hole is not smaller than the inner diameter of the inner sheath main pipeline, the area of the inner sheath side hole is not smaller than the inner section area of the inner sheath main pipeline, and the stone removing efficiency is improved. The concrete solution is for the pipe diameter that the sheath side opening is close to the sheath trunk line in the maximize, adopts the bigger middle-section negative pressure suction sleeve pipe of diameter to overlap outside the sheath trunk line, and increase strength, middle-section negative pressure suction sleeve pipe set up the negative pressure suction side opening in the position corresponding with the sheath side opening, connect the negative pressure collateral branch, and the internal diameter of negative pressure collateral branch is greater than the internal diameter of sheath trunk line, ensures that the clear stone is smooth and easy. The diameter of the negative pressure suction side hole is larger than that of the inner sheath main pipeline.

The negative pressure side branch connected with the middle section negative pressure suction sleeve is provided with a negative pressure control through hole, and the size of the negative pressure can be simply and conveniently adjusted at any time by adopting a thumb in the operation, so that the clear visual field and the high stone cleaning efficiency are ensured. The area of the negative pressure control through hole is smaller than the area of the inner surface of the thumb.

The length of the front end of the inner sheath main pipeline extending out of the front end of the front-section water inlet sleeve can be selected in various ways, the shorter the selection is, the higher the efficiency is; long can reach deeper and obese patients. The length of the front end of the main internal sheath pipeline extending out of the front end of the middle negative pressure suction sleeve is 4-30 cm.

The inner diameter of the inner sheath main pipeline can be selected in various ways, the stone-seeking efficiency is improved by selecting the larger the inner diameter, and the thicker the inner diameter is, the higher the inner diameter is; when in specific use, if the giant stones are coarse, the stones are efficiently removed; 2cm of small stones can be selected to be thin, so that the kidney channel injury is reduced; the inner diameter of the main pipe of the inner sheath is 1-12 mm.

The tail end of the inner sheath main pipeline extends out of the tail end of the middle section negative pressure sleeve, and the length of the tail end of the middle section negative pressure sleeve is designed to be different in size according to the change of a nephroscope. The tail end of the inner sheath main pipeline extends out of the tail end of the middle-section negative pressure suction sleeve in different lengths and can be correspondingly matched with different ureteroscopes or nephroscopes; if the clinical ureteroscope head section commonly used is thin at 9cm, and the rear part is thick, the length of the tail end of the inner sheath main pipeline extending out of the tail end of the middle-section negative pressure suction sleeve can be selected to be 10cm, water leakage is avoided, and the water-proof difficulty of the water-proof cap is reduced; if some other nephroscopes are used and the front and the back of the nephroscope are as thick as each other, the length of the tail end of the inner sheath main pipeline extending out of the tail end of the middle-section negative pressure suction sleeve can be selected to be short, the in-out resistance is reduced, and the shortest length can enable the waterproof cap to be directly sleeved on the tail part of the middle-section negative pressure suction sleeve; the length of the main pipe of the inner sheath extending out of the tail end of the middle-section negative pressure suction sleeve is 0-10 cm.

The tail end of the inner sheath main pipeline is hermetically connected with the nephroscope or the soft lens, and in order to further realize the sealing of the nephroscope or the soft lens and the inner sheath main pipeline, the utility model further comprises an inner sheath tail step and a waterproof cap; a coaxial inner sheath tail step is arranged at the tail part of the inner sheath main pipe and positioned on the outer wall of the inner sheath main pipe, the inner sheath tail step is annular, the inner diameter of the inner sheath tail step is equal to the outer diameter of the inner sheath main pipe, and the inner sheath tail step and the inner sheath main pipe are connected into a whole; the tail end of the inner sheath main pipeline is covered with a waterproof cap; the center of the waterproof cap is provided with a through hole; thereby preventing the waterproof cap from slipping through the inner sheath tail step and preventing the inner sheath main pipeline from air leakage. The medical endoscope comprises a uretero-nephroscope, an SMP nephroscope, a UMP nephroscope, an F4.8 ultramicro percutaneous nephroscope, a bladder soft lens or a uretero-soft lens and the like, wherein the waterproof cap is made of elastic materials such as rubber, the inner diameter of a through hole is smaller than the outer diameter of the nephroscope or the soft lens, the nephroscope or the soft lens extends into the main pipe of the inner sheath through the through hole in the center of the waterproof cap, the waterproof cap is elastically sleeved on the outer wall of the nephroscope or the soft lens so as to realize sealing, and the nephroscope or the soft lens can enter and exit the main pipe of the inner sheath from the.

The inner diameter of the main conduit of the inner sheath is larger than the outer diameter of the nephroscope or the soft scope.

The main pipe of the inner sheath, the negative pressure suction sleeve of the middle section, the negative pressure side branch, the clapboard, the water inlet sleeve of the front section, the water inlet side branch and the tail step of the inner sheath are made of metal materials or high polymer materials, and the large-scale production can be realized. The metal material such as stainless steel material can be used repeatedly; or a polymeric material such as plastic, which can be sterilized at one time.

The utility model discloses can adopt two ways of watering in the art: the nephroscope mainly waters, and the anterior segment is intake the sleeve pipe and is supplementary, and perhaps the anterior segment is intake the sleeve pipe and is mainly watered, and the nephroscope is supplementary to adapt to different demands: 1. the front section water inlet sleeve is mainly used for irrigation and is assisted by a nephroscope to be suitable for stone removal; 2. the nephroscope is mainly irrigated, and the front section water inlet sleeve is assisted to adapt to distant stones such as ureter or renal calyx.

The utility model discloses a various different internal diameters's various urinary system calculi such as kidney stone, vesical calculus, ureteral calculus and urethra stone can be adapted to in the cooperation of the various uretero-nephroscope of various different internal diameters.

The utility model has the advantages that:

the utility model discloses use and have in the clear stone art of percutaneous kidney passageway rubble or in the urethra bladder stone rubble art: 1. improving the field definition in the operation: the visual field is kept clear, and stone powder, pus, blood clots and the like can be quickly removed during stone breaking under continuous perfusion and negative pressure suction, so that the operation is kept under the clear visual field; 2. the problems of stone backflow and escape are solved: the stone can be prevented from flowing back and escaping under the negative pressure suction, the stone cleaning difficulty is reduced, and the bleeding risk when the stone is searched is reduced; 3. effectively reducing the pressure in the cavity and reducing the operation risk: continuous suction and simultaneous perfusion can form uninterrupted liquid circulation, the pressure condition in the cavity can be observed and adjusted at any time, the cavity is kept in a low-pressure state, the heating probability is reduced, and the operation safety is improved; 4. the stone removing efficiency is improved, small stones are simultaneously sucked out under negative pressure during stone breaking, the stone removing rate is improved, and the operation time is reduced; 5. the use of the stone removing instrument is avoided, when the stone is larger but smaller than the diameter of the inner sheath, the stone automatically escapes to the negative pressure side hole while withdrawing the scope under the negative pressure, instruments such as a stone bag, a stone removing clamp and the like are not needed, and the equipment consumption and the burden of a patient are reduced.

Drawings

Fig. 1 is a cross-sectional view of one embodiment of an assembled circulating uninterrupted perfusion adjustable negative pressure stone removal sheath assembly of the present invention;

fig. 2 is a schematic view of an inner sheath main pipe of an embodiment of the assembled circulating uninterrupted perfusion adjustable negative pressure stone removing sheath kit of the present invention;

fig. 3 is a schematic view of a middle section negative pressure suction sleeve of an embodiment of the assembled circulating uninterrupted perfusion adjustable negative pressure stone removal sheath assembly of the present invention;

fig. 4 is a schematic view of the negative pressure side branch of an embodiment of the assembled circulating uninterrupted perfusion adjustable negative pressure stone removal sheath assembly of the present invention;

fig. 5 is a schematic view of a front section water inlet sleeve of an embodiment of an assembled circulating uninterrupted perfusion adjustable negative pressure stone removal sheath assembly of the present invention;

fig. 6 is a schematic view of the water inlet side branch of an embodiment of the assembled circulating uninterrupted perfusion adjustable negative pressure stone removal sheath assembly of the present invention;

FIG. 7 is a schematic view of the front sheath of one embodiment of an assembled recirculating non-interruptive irrigating adjustable negative pressure stone removal sheath kit of the present invention;

fig. 8 is a schematic view of an inner sheath tail step of an embodiment of an assembled circulating uninterrupted perfusion adjustable negative pressure stone removal sheath assembly of the present invention;

fig. 9 is a schematic view of a coupling nephroscope according to an embodiment of the assembled circulating uninterrupted perfusion adjustable negative pressure stone removal sheath assembly of the present invention.

Detailed Description

The invention will be further elucidated by means of specific embodiments in the following with reference to the drawings.

As shown in fig. 1, the assembled circulation uninterrupted perfusion adjustable negative pressure stone removing sheath assembly of the present embodiment comprises: the device comprises an inner sheath main pipeline 1, an inner sheath side hole 11, a middle-section negative pressure suction sleeve 2, a negative pressure suction side hole 21, a negative pressure side branch 3, a negative pressure control through hole 31, a partition plate 4, a front-section water inlet sleeve 5, a water inlet side hole 51, a water inlet side branch 6, a front-section sheath 7, an inner sheath tail step 8 and a waterproof cap; wherein, the main pipe 1 of the inner sheath is a straight pipe with hollow interior; a coaxial middle-section negative pressure suction sleeve 2 is sleeved outside the inner sheath main pipe 1 and positioned at the middle section, the middle-section negative pressure suction sleeve 2 is cylindrical, and the inner diameter of the middle-section negative pressure suction sleeve 2 is larger than the outer diameter of the inner sheath main pipe 1; an inner sheath side hole 11 is formed in the side wall of the inner sheath main pipeline 1, and a negative pressure suction side hole 21 is formed in the side wall of the middle section negative pressure suction sleeve 2 and in the position opposite to the inner sheath side hole 11; the negative pressure side branch 3 is communicated to the inner sheath main pipeline 1 through a negative pressure suction side hole 21 and an inner sheath side hole 11, and a negative pressure control through hole 31 is formed in the side wall of the negative pressure side branch 3; a coaxial front-section water inlet sleeve 5 is arranged outside the inner sheath main pipe 1 and in front of the middle-section negative pressure suction sleeve 2, and the inner diameter of the front-section water inlet sleeve 5 is larger than the outer diameter of the inner sheath main pipe 1; a coaxial baffle plate 4 is arranged between the front section water inlet sleeve 5 and the middle section negative pressure suction sleeve 2, the baffle plate 4 is annular, the plane of the baffle plate 4 is vertical to the axis of the inner sheath main pipeline 1, and the inner diameter of the baffle plate 4 is equal to the outer diameter of the inner sheath main pipeline 1, so that the front section water inlet sleeve 5 is not communicated with the middle section negative pressure suction sleeve 2; a water inlet side hole 51 is formed in the side wall of the front section water inlet sleeve 5, and the water inlet side branch 6 is communicated to the front section water inlet sleeve 5 through the water inlet side hole 51; the front section sheath 7 is spliced at the front end of the coaxial front section water inlet sleeve 5 in a sealing way, and the outer diameter of the front section sheath 7 is equal to the inner diameter of the front section water inlet sleeve 5; the inner diameter of the front section sheath 7 is larger than the outer diameter of the inner sheath main pipe 1, and an annular water inlet channel is formed between the outer wall of the inner sheath main pipe 1 and the inner walls of the front section water inlet sleeve 5 and the front section sheath 7; a coaxial inner sheath tail step 8 is arranged at the tail part of the inner sheath main pipe 1 and positioned on the outer wall of the inner sheath main pipe 1, the inner sheath tail step 8 is annular, and the inner diameter of the inner sheath tail step 8 is equal to the outer diameter of the inner sheath main pipe 1 and is connected with the inner sheath main pipe 1 into a whole; the tail end of the inner sheath main pipeline 1 is covered with a waterproof cap; the center of the waterproof cap is provided with a through hole; the water inlet side branch 6 is connected with a water inlet pipe, physiological saline is filled into the front-section water inlet sleeve 5 from the water inlet side branch 6, flows forwards to the front end of the inner sheath main pipe 1 through a water inlet channel, and flows into the inner sheath main pipe 1 from the front end of the inner sheath main pipe; the negative pressure side branch 3 is connected with a negative pressure aspirator through a negative pressure pipe, and negative pressure is formed in the inner sheath main pipeline 1; the negative pressure control through hole 31 is pressed intermittently by the thumb to adjust the negative pressure.

As shown in fig. 2, the main internal sheath conduit 1 is a straight conduit with a hollow interior, and an internal sheath side hole 11 is formed in the side wall.

As shown in fig. 3, the inner diameter of the middle stage negative pressure suction cannula 2 is larger than the outer diameter of the main sheath conduit 1, and a negative pressure suction side hole 21 is opened in a position facing the inner sheath side hole 11 in the side wall of the middle stage negative pressure suction cannula 2.

As shown in fig. 4, a negative pressure control through hole 31 is formed in the side wall of the negative pressure side branch 3.

As shown in fig. 5, the inner diameter of the front water inlet sleeve 5 is larger than the outer diameter of the main sheath pipe 1, and a water inlet side hole 51 is opened on the side wall of the front water inlet sleeve 5.

As shown in fig. 6, the water inlet side branch 6 is connected to the front water inlet pipe 5 through a water inlet side hole 51.

The anterior sheath 7 is shown in figure 7.

As shown in fig. 8, the inner sheath tail step 8 is annular.

In the embodiment, the size of kidney stone is about 3cm, the instrument is suitable for percutaneous nephrolithotomy, a minimally invasive percutaneous nephrolithotomy (mPCNL) is selected, a thin STOZE uretero-nephroscope is selected as a conventional F16 channel, the rear section of the endoscope body is 4mm in circular diameter, a holmium laser is used for lithotripsy equipment, and a holmium laser optical fiber with the diameter of 0.5mm is selected. Under the condition, the size of the assembled circulating uninterrupted perfusion adjustable negative pressure stone removing sheath component is as follows: the stainless steel pipe of 5mm thickness 0.25mm external diameter is selected for use to the interior sheath trunk line, and the anterior segment is intake the sleeve pipe and is all selected for use to the middle section negative pressure suction sleeve pipe that external diameter 6.5mm thickness 0.25mm stainless steel pipe. The length that the front end of interior sheath trunk line stretches out anterior segment water inlet sleeve's front end is 14 cm: in this case, since the STOZE ureteroscope section is thin at 9cm and the rear part is thick, in order to avoid water leakage, the length of the tail end of the main conduit of the inner sheath extending out of the tail end of the middle-section negative pressure suction sleeve is 10 cm.

The skin puncture point is generally 10-12 cm lateral to the spinal column, 12 subcostal or 11 intercostals behind the posterior axillary line. The puncture site and direction are first determined under B-mode ultrasonography/fluoroscopy. The puncture site skin is a small incision. After the puncture needle enters the renal capsule, the puncture needle moves up and down along with respiration, at the moment, the needle point enters 1.5-2cm again under the direct ultrasonic vision, the needle point can enter the renal calyx, and the urine overflow is observed. The guide wire is sent to renal calyx, renal pelvis and ureter through puncture needle. The soft part of the front end of the guide wire is required to completely enter the renal pelvis or calyx. The products which are commercialized at the previous stage are widely applied in clinic, then the channel is gradually expanded by using the percutaneous pyelosis expansion kit, the sheath which can be torn off and is left F16 is kept, the percutaneous renal channel is established, and the uretero-nephroscope can be observed through the channel without errors. The method and the equipment are the conventional clinical application methods and equipment.

The operation method of the assembled circulating uninterrupted perfusion adjustable negative pressure stone removing sheath assembly comprises the following steps:

1. before the channel puncture, the tail part of the tearable sheath is cut to be suitable for size, the tail part of the tearable sheath is spliced with the front-section water inlet sleeve of the stone cleaning sheath kit in advance, the in vitro test depth is suitable and water does not leak, and then the tearable sheath is detached;

2. the percutaneous renal passage is established as described above, and the support passage with the outer sheath capable of being torn off is reserved in the human body;

3. splicing the tearable sheath and the front-section water inlet sleeve at the human body part to ensure that the spliced part is watertight;

4. connecting a water inlet pipe to the port of the water inlet side branch, filling physiological saline, and connecting the negative pressure side branch to a negative pressure aspirator through a negative pressure pipe;

5. the uretero-renoscope is also connected with another water inlet pipeline and is filled with physiological saline, and then extends into the main pipeline of the inner sheath through the through hole in the center of the waterproof cap, as shown in fig. 9, the uretero-renoscope reaches the head of the main pipeline of the inner sheath, so that the renal calyx can be observed, and the position is ensured to be accurate;

6. after stones are seen clearly, the stones enter a holmium laser optical fiber from a channel in a ureteroscope, and holmium laser lithotripsy operation under a percutaneous nephroscope is carried out;

7. an operator can fix the stone removing sheath component on one hand to prevent the channel from being lost, and intermittently press the negative pressure control through hole on the negative pressure side branch with a thumb to adjust the negative pressure in the main pipe of the inner sheath, the thumb presses the negative pressure control through hole to form sealing, under the suction of the negative pressure suction apparatus, the negative pressure in the main pipe of the inner sheath is increased, the thumb does not press the negative pressure control through hole, the external atmospheric pressure enters, the negative pressure in the main pipe of the inner sheath is reduced, and the low pressure in the renal pelvis is ensured under the condition of clear visual field;

8. small stone fragments or small blood clots can be sucked out through the negative pressure side branch; the diameter of larger fragments is smaller than the inner diameter of the inner sheath, the uretero-nephroscope can move back in the main pipe of the inner sheath, stone fragments can enter the main pipe of the inner sheath along with the action of water flow and negative pressure, when the uretero-nephroscope moves back behind the side hole of the inner sheath of the main pipe of the inner sheath, stones can be sucked out of the body along with the side branch of the negative pressure, and the adjustable negative pressure stone removing sheath component can be used for rapidly removing stones after the stones are crushed by holmium laser;

9. after the stone is cleaned, the tearable sheath is detached from the connection with the front-section water inlet sleeve;

10. the F12 nephrostomy tube is remained through the channel of the removable sheath, 3ml of water is injected into the air bag, the removable sheath is removed from the body and then is torn into two halves, the nephrostomy tube is fixed, and the operation is finished, wherein F represents the perimeter and has the unit of mm.

Finally, it is noted that the disclosed embodiments are intended to aid in further understanding of the invention, but will be understood by those skilled in the art that: various substitutions and modifications are possible without departing from the spirit and scope of the present invention and the appended claims. Therefore, the present invention should not be limited to the embodiments disclosed, and the scope of the present invention is defined by the appended claims.

Claims

1. An assembled circulating uninterrupted perfusion adjustable negative pressure stone-removing sheath assembly, comprising: the device comprises an inner sheath main pipeline, an inner sheath side hole, a middle-section negative pressure suction sleeve, a negative pressure suction side hole, a negative pressure side branch, a negative pressure control through hole, a front-section water inlet sleeve, a water inlet side hole, a water inlet side branch and a front-section sheath; the inner sheath main pipeline is a straight pipeline with a hollow interior; a coaxial middle-section negative pressure suction sleeve is sleeved outside the inner sheath main pipe and positioned at the middle section, the middle-section negative pressure suction sleeve is cylindrical, and the inner diameter of the middle-section negative pressure suction sleeve is larger than the outer diameter of the inner sheath main pipe; an inner sheath side hole is formed in the side wall of the inner sheath main pipeline, and a negative pressure suction side hole is formed in the side wall of the middle-section negative pressure suction sleeve and in the position opposite to the inner sheath side hole; the negative pressure side branch is communicated to the inner sheath main pipeline through a negative pressure suction side hole and an inner sheath side hole; a negative pressure control through hole is formed in the side wall of the negative pressure side branch; a front-section water inlet sleeve which is hermetically connected and coaxial is arranged outside the main internal sheath pipeline and in front of the middle-section negative pressure suction sleeve, the inner diameter of the front-section water inlet sleeve is larger than the outer diameter of the main internal sheath pipeline, a water inlet side hole is formed in the side wall of the front-section water inlet sleeve, and a water inlet side branch is communicated to the front-section water inlet sleeve through the water inlet side hole; the front section sheath is spliced at the front end of the coaxial front section water inlet sleeve in a sealing way; the inner diameter of the front-section sheath is larger than the outer diameter of the inner sheath main pipe, and an annular water inlet channel is formed between the outer wall of the inner sheath main pipe and the inner walls of the front-section water inlet sleeve and the front-section sheath; the water inlet side branch is connected with a water inlet pipe, physiological saline is filled into the front-section water inlet sleeve from the water inlet side branch, flows forwards to the front end of the inner sheath main pipeline through a water inlet channel, and flows into the inner sheath main pipeline from the front end of the inner sheath main pipeline; the negative pressure side branch is connected with a negative pressure aspirator through a negative pressure pipe, and negative pressure is formed in the inner sheath main pipeline; the negative pressure control through hole is discontinuously pressed by the thumb to adjust the negative pressure.

2. The modular, cyclical, uninterrupted perfusion, adjustable negative pressure lithotomy sheath assembly of claim 1, wherein said anterior sheath is a matching, tearable sheath; or a plurality of metal sheaths are adopted and assembled into a tubular shape.

3. The assembled circulating uninterrupted perfusion adjustable negative pressure stone-clearing sheath kit of claim 1, wherein the diameter of the inner sheath side hole is not smaller than the inner diameter of the inner sheath main pipe; the diameter of the negative pressure suction side hole is larger than that of the inner sheath main pipeline.

4. The assembled circulating uninterrupted perfusion adjustable negative pressure stone removing sheath set according to claim 1, wherein the front end of the front-section water inlet sleeve is sleeved on the outer side wall of the tail end of the front-section outer sheath, the inner diameter of the front-section water inlet sleeve is equal to the outer diameter of the front-section outer sheath, or the outer diameter of the front-section water inlet sleeve is equal to the inner diameter of the front-section outer sheath.

5. The modular, recirculating, non-interruptible perfusion, adjustable negative pressure stone-clearing sheath assembly according to claim 1 wherein the internal diameter of said negative pressure side branch is larger than the internal diameter of the main internal sheath conduit.

6. The modular, cyclical, uninterrupted perfusion, adjustable negative pressure lithotomy sheath kit according to claim 1, wherein the negative pressure control through hole has an area that is smaller than an inner surface area of the thumb.

7. The assembly type circulation uninterrupted perfusion adjustable negative pressure stone removing sheath assembly according to claim 1, wherein the seal between the front section water inlet sleeve and the middle section negative pressure suction sleeve is welded by the front section water inlet sleeve and the middle section negative pressure suction sleeve, or a coaxial clapboard is arranged between the front section water inlet sleeve and the middle section negative pressure suction sleeve, and the clapboard is in a circular ring shape.

8. The assembled circulating uninterrupted perfusion adjustable negative pressure stone removing sheath assembly according to claim 1, wherein the length of the front end of the inner sheath main pipeline extending out of the front end of the middle negative pressure suction sleeve is 4-30 cm; the length of the main pipe of the inner sheath extending out of the tail end of the middle-section negative pressure suction sleeve is 0-10 cm.

9. The assembled circulating uninterrupted filling adjustable negative pressure stone removing sheath assembly according to claim 1, further comprising an inner sheath tail step and a waterproof cap, wherein the coaxial inner sheath tail step is arranged at the tail part of the inner sheath main pipe and positioned on the outer wall of the inner sheath main pipe, the inner sheath tail step is annular, and the inner diameter of the inner sheath tail step is equal to the outer diameter of the inner sheath main pipe and is connected with the inner sheath main pipe into a whole; the tail end of the inner sheath main pipeline is covered with a waterproof cap; the center of the waterproof cap is provided with a through hole.

10. The assembled circulating uninterrupted perfusion adjustable negative pressure stone removing sheath assembly according to claim 9, wherein the main inner sheath pipe, the middle negative pressure suction sleeve, the negative pressure side branch, the front water inlet sleeve, the water inlet side branch and the tail step of the inner sheath are made of metal materials or high polymer materials.