CN212234669U - Expansion incision device - Google Patents

Expansion incision device Download PDF

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Publication number
CN212234669U
CN212234669U CN202021612053.6U CN202021612053U CN212234669U CN 212234669 U CN212234669 U CN 212234669U CN 202021612053 U CN202021612053 U CN 202021612053U CN 212234669 U CN212234669 U CN 212234669U
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Prior art keywords
incision
shell body
outer shell
expansion
handle
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CN202021612053.6U
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Chinese (zh)
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黄永辉
闫秀娥
常虹
张耀朋
王迎春
郑炜
刘文正
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Peking University Third Hospital Peking University Third Clinical Medical College
Peking University Third Hospital
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Peking University Third Hospital Peking University Third Clinical Medical College
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Abstract

The utility model discloses an expansion incision device, relating to an operation tool, comprising an outer shell, an expansion element and an incision component, wherein the expansion element is arranged at one end of the outer shell, and is communicated with the inside of the outer shell, the expansion element is used for drilling into and expanding a puncture path between the narrow section of the bile-pancreatic duct and the lumen of the digestive tract, the side wall of the outer shell is provided with a chute which is communicated with the inner cavity of the outer shell and the outside, the incision component comprises an incision knife and a sliding handle, the incision knife is arranged in the outer shell, the sliding handle is sleeved on the periphery of the outer shell, one end of the expansion element is provided with a communication hole which is communicated with the inner cavity of the expansion element and the outside, the sliding handle can drive the incision knife to reciprocate in the extending direction of the outer shell and lead the incision knife to extend out, the dilation incision device can smoothly pass through a severe narrow section of a cholepancreatic duct, dilates the severe narrow section, and can be used for dilating a puncture path between digestive tract lumens.

Description

Expansion incision device
Technical Field
The utility model relates to a surgical tool, in particular to an expansion incision device.
Background
Endoscopic Retrograde Cholangiopancreatography (ERCP) and ultrasound Endoscopy (EUS) are the two techniques that have been developed the fastest and the most new techniques have emerged in recent years. At present, most of benign diseases and partial malignant diseases of the biliary-pancreatic system can be diagnosed and treated by the two technologies and the derivative technologies thereof, and a plurality of patients benefit from the diagnosis and treatment.
ERCP is mainly inserted into different accessories aiming at different diseases through a therapeutic forceps channel of a duodenoscope, thereby achieving the purposes of diagnosis and treatment. However, some diseases can not be treated by the existing accessories, for example, some biliary pancreatic duct stenosis diseases, whether benign or malignant, are diagnosed and treated by the following steps: (1) the duodenoscope is inserted to the papilla, and is sent to a papilla incision knife and a guide wire through a forceps channel, and then a bile duct and/or a pancreatic duct is/are selectively inserted into the tube under the guide of the guide wire; (2) after the guide wire successfully enters a bile duct and a pancreatic duct system, injecting a contrast medium into the bile duct and the pancreatic duct to determine the narrow part and degree; (3) if malignant biliary stricture is suspected, biopsy is required to be carried out in the stricture section to obtain pathological evidence, pancreatic ducts are easy to cause pancreatic duct injury after biopsy due to special physiological structures of the pancreatic ducts, severe complications such as acute pancreatitis occur, and the malignant stricture of the pancreatic ducts can be clearly diagnosed from preoperative imaging generally, so the pancreatic ducts are not generally subjected to biopsy; (4) if the stenosis is particularly severe, with a diameter of less than 4.4Fr (i.e., the papillotomy knife cannot pass through the stenosis under guide of the guide wire), or if the papillotomy knife cannot pass through the stenosis without dilation to meet the requirements of the next stent placement, further dilation treatment of the stenosis is required. Existing expansion modes include step-by-step expanders (including Sohendra step-by-step expansion bougies and Sohendra stent retrievers) and step-by-step expansion balloons. However, in clinical practice, some patients have serious stenosis, especially benign stenosis, which cannot pass through the stenosis smoothly in the two ways, and cannot dilate the stenosis, so that the patients in the clinical practice can only select operation subsequently, and perform EUS-guided interventional therapy in some conditional hospitals.
EUS is currently clinically primarily a tripartite effect: (1) diagnosing the disease by ultrasound imaging; (2) performing fine needle aspiration biopsy or suction on tissues through forceps channel insertion and aspiration of the EUS, and pathologically diagnosing diseases after the tissues are obtained; (3) a series of interventional therapies (mainly comprising EUS-guided pseudocyst drainage, EUS-guided bile duct drainage, EUS-guided pancreatic duct drainage, EUS-guided gallbladder puncture drainage and EUS-guided gastrointestinal anastomosis) are carried out under the guidance of EUS. In EUS guided intervention, the following steps are required: (1) selecting a proper puncture point by the EUS; (2) under the guidance of EUS, the puncture needle is punctured into a target organ or lesion (bile duct, pancreatic duct, gall bladder, pseudocyst or jejunum) through the stomach or through the duodenum; (3) after the guide wire is kept in a target organ or lesion, a Sohendra dilator is used for dilating the puncture channel under the guide of the guide wire, or a cutting knife is used for electrifying and cutting the puncture path, so that a drainage tube or a stent can be further placed in the puncture channel; (4) after the puncture channel is expanded, a drainage tube and a bracket are arranged under the guidance of X-ray and ultrasonic endoscope. The implementation of the step (3) is important for the subsequent successful treatment, but the fibrous scar formation on the puncture path of some patients is obvious, so that the dilator cannot smoothly enter the puncture channel, and abundant small blood vessels exist on the puncture path, and the large hemorrhage which cannot be rescued can occur by simply applying the incision device, and the purpose of safe dilation cannot be achieved.
SUMMERY OF THE UTILITY MODEL
The utility model aims at providing an expansion opens device to solve the problem that above-mentioned prior art exists, make this expansion open device can be smoothly through the serious narrow section of bile pancreatic duct, expand serious narrow section, and can expand the puncture route between the alimentary canal lumen
In order to achieve the above object, the utility model provides a following scheme:
the utility model provides an expansion cutting device, include shell body, expansion element and open the subassembly, expansion element locates shell body one end, and with the inside intercommunication of shell body, expansion element is used for boring into and expands the puncture route between the narrow section of bile pancreatic duct and the alimentary canal lumen, the lateral wall of shell body is equipped with the spout, the spout intercommunication shell body inner chamber and external, open the subassembly including incision sword and sliding handle, the incision sword is located in the shell body, the sliding handle cover is located the shell body periphery, expansion element's one end is equipped with the intercommunicating pore, the intercommunicating pore intercommunication expansion element inner chamber and external world, the sliding handle can drive the incision sword is in the extending direction reciprocating motion of shell body, and make the incision sword passes through the intercommunicating pore stretches out the shell body.
Preferably, the outer casing is a round pipe body, the expansion element is conical, the large end of the expansion element is fixedly connected with the outer casing, and threads are arranged on the periphery of the expansion element.
Preferably, the expansion element is 2-3cm in length.
Preferably, an electrical plug is arranged on the sliding handle, one end of the electrical plug is used for being electrically connected with an external power supply device, the other end of the electrical plug is fixedly connected with the incision knife and used for electrifying the incision knife, and the incision knife is a needle-shaped incision knife.
Preferably, the sliding handle comprises two circular rings and a connecting section, the connecting section is sleeved on the periphery of the outer shell, the two circular rings are respectively fixed at two ends of the connecting section, and the arrangement direction of the two circular rings is perpendicular to the length direction of the incision knife.
Preferably, a handle is arranged at one end of the outer shell body far away from the expansion element, and the handle is annular and is used for being held by an operator.
Preferably, the outer shell is provided with scales on the periphery for an operator to observe the length of the cutting knife extending out of the communication hole.
Preferably, a limiting element is fixedly arranged at one end, close to the expansion element, of the outer shell, and the limiting element is sleeved on the periphery of the outer shell and used for limiting the sliding handle and preventing the sliding handle from falling off or shifting from the expansion element.
The utility model discloses for prior art gain following technological effect:
the utility model provides an expansion incision device, which comprises an outer shell, an expansion element and an incision component, wherein the expansion element is arranged at one end of the outer shell and is communicated with the inside of the outer shell, the expansion element is used for drilling and expanding a puncture path between a narrow section of a bile pancreatic duct and a digestive tract lumen so as to lead in a subsequent operation device, the side wall of the outer shell is provided with a chute which is communicated with the inner cavity of the outer shell and the outside, the incision component comprises an incision knife and a sliding handle, the incision knife is arranged in the outer shell so as to accommodate the incision knife in the chute when incision is not needed, the sliding handle is sleeved on the periphery of the outer shell so as to conveniently and directly apply force to the sliding handle, one end of the expansion element is provided with a communication hole which is communicated with the inner cavity of the expansion element and the outside and is used for extending and extending of the incision knife, the sliding handle can drive the incision knife to reciprocate in the extending, ordinary stenosis directly adopts mechanical expansion through the extension element, it is relatively safe, when serious stenosis, can't directly pass through the narrow section and when expanding through the extension element, through with the smooth handle to the direction removal near the extension element, drive the incision sword to the direction removal near the intercommunicating pore, stretch out through the intercommunicating pore until the pointed end of incision sword, control incision sword carries out the microcutting to the narrow section, the incision sword is withdrawed through removing the smooth handle after the cutting is accomplished, and expand through the extension element, realize the expansion of serious narrow section or puncture route, and, the extension element is inside can pass through the seal wire, use the expansion and the cutting of seal wire guide narrow section, safety and reliability.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings required to be used in the embodiments will be briefly described below, and it is obvious that the drawings in the following description are only some embodiments of the present invention, and for those skilled in the art, other drawings can be obtained according to these drawings without creative efforts.
FIG. 1 is a front view of the expanding incision device of the present invention in an expanded state;
FIG. 2 is a bottom view of the dilating incision device of FIG. 1;
FIG. 3 is a front view of the expanding incision device of the present invention in an open state;
FIG. 4 is a bottom view of the dilating incision device of FIG. 3;
in the figure: 1-outer shell, 11-chute, 2-expanding element, 31-ring, 32-connecting section, 4-electric plug, 5-incision knife, 6-limiting element and 7-handle.
Detailed Description
The technical solutions in the embodiments of the present invention will be described clearly and completely with reference to the accompanying drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only some embodiments of the present invention, not all embodiments. Based on the embodiments in the present invention, all other embodiments obtained by a person skilled in the art without creative work belong to the protection scope of the present invention.
The utility model aims at providing an expansion incision device to solve the current serious narrow section that is used for the annex of expansion can't pass through the bile pancreatic duct, more can't carry out the technical problem that expands to serious narrow section and alimentary canal lumen puncture route.
In order to make the above objects, features and advantages of the present invention more comprehensible, the present invention is described in detail with reference to the accompanying drawings and the detailed description.
As shown in figures 1-4, the utility model provides an expansion incision device, which comprises an outer shell 1, an expansion element 2 and an incision component, wherein the expansion element 2 is arranged at one end of the outer shell 1 and is communicated with the inside of the outer shell 1, the expansion element 2 is used for drilling and expanding the narrow section of the bile pancreatic duct or the puncture path between the lumens of the digestive tract so as to lead in a subsequent operation device, the side wall of the outer shell 1 is provided with a chute 11, the chute 11 is communicated with the inner cavity of the outer shell 1 and the outside, the incision component comprises an incision knife 5 and a sliding handle, the incision knife 5 is arranged in the outer shell 1, thereby when the incision is not needed, the incision knife 5 is contained in the chute 11, the sliding handle is sleeved on the periphery of the outer shell 1 so as to directly apply force to the sliding handle, one end of the expansion element 2 is provided with a communication hole which is communicated with the inner cavity of the expansion element 2 and the outside, the sliding handle can drive the cutting knife 5 to reciprocate in the extending direction of the outer shell 1, and the cutting knife 5 is enabled to extend out of the outer shell 1 through the communicating hole, the common stenosis directly adopts mechanical expansion through the expansion element 2, the mechanical expansion is relatively safe, the expansion and incision device is in an expansion state (figure 1-figure 2) during the mechanical expansion, when the severe stenosis cannot directly pass through the stenosis section and is expanded through the expansion element 2, the sliding handle is moved towards the direction close to the expansion element 2 to drive the cutting knife 5 to move towards the direction close to the communicating hole until the tip of the cutting knife 5 extends out through the communicating hole, at the moment, the expansion and incision device is in an incision state (figure 3-figure 4), the cutting knife 5 is controlled to slightly cut the stenosis section, after the cutting is finished, the cutting knife 5 is retracted through the moving sliding handle, the expansion element 2 is used for expansion, and the severe stenosis section or puncture path is realized, in addition, the guide wire can be used for guiding the expansion and incision of the narrow section through the guide wire in the expansion element, so that the expansion element is safe and reliable.
Specifically, shell body 1 is the pipe body, and extension element 2 is conical, and extension element 2's main aspects and shell body 1 fixed connection, can make extension element 2's pointed end earlier through narrow section (or puncture route), expand step by step, protect the patient, and extension element 2 periphery is equipped with the screw thread, and at the actual expansion in-process, through rotatory shell body 1, drive the spiral expansion of going into of extension element 2, reduce the expansion resistance.
2 length of extension element is 2-3cm, and the diameter of extension element and shell body junction is 7Fr or 8.5Fr, and extension element be equipped with one with shell body junction periphery and not pass through X line coating mark, and the width is 2mm, and under the expanded state, the length of this expansion cutting device is 200cm, but above-mentioned size is only a concrete embodiment, in actual production process, the utility model provides an expansion cutting device's size is not limited to above-mentioned limited, and the technical personnel in the art can make the adaptability change to each size according to actual expansion needs.
Be equipped with electric plug 4 on the sliding handle, the one end of electric plug 4 is used for being connected with external power supply unit electricity, and the other end of electric plug 4 and incision sword 5 fixed connection are used for cutting 5 circular telegrams, and when incision sword 5 removed and target in place, the intercommunication of accessible electric plug 4 external power supply unit realization circuit adopts the high frequency current cutting, safe and reliable, and incision sword 5 is aciculiform incision sword 5, can realize cutting a little, reduces the damage to the patient.
The sliding handle comprises two circular rings 31 and a connecting section 32, the periphery of the outer shell 1 can be sleeved with the connecting section 32, the periphery of the outer shell 1 can slide in a reciprocating mode, the two circular rings 31 are fixed at two ends of the connecting section 32 respectively, the arrangement direction of the two circular rings 31 is perpendicular to the length direction of the incision knife 5, an operator can hold the sliding handle conveniently, and the sliding handle can be directly used for passing through the circular rings 31 through fingers to apply force and is convenient to hold.
Keep away from the one end of extension element 2 on shell body 1 and be equipped with handle 7, handle 7 is cyclic annular, be used for the operator to hand, when carrying out spiral drilling to extension element 2, direct act on handle 7 through the finger, it is rotatory to drive shell body 1 through handle 7, and then drive extension element 2 rotatory can, convenient operation, it is more excellent, be equipped with the seal wire hole on the handle, the seal wire hole can communicate inside the handle, inside shell body inner chamber and the extension element, make the seal wire can open the device through this expansion smoothly.
The 1 periphery of shell body is equipped with the scale, a length for supplying the operator to observe that incision sword 5 stretches out the intercommunicating pore, when the smooth handle drives incision sword 5 and removes, the smooth handle removes to the equal ability of optional position and corresponds directional scale interval, guarantee that incision sword 5's arbitrary length of stretching out is all readable, and guarantee the accuracy, thereby according to the scale of smooth handle position, calculate the length that incision sword 5 stretches out the intercommunicating pore, can effective control out needle length, safety and reliability, it is more excellent, scale on the shell body also can directly stretch out length with incision sword 8 and correspond, the scale of smooth handle position promptly is incision sword 9 and stretches out length, the reading is more directly perceived convenient.
The fixed spacing component 6 that is equipped with of one end that is close to expansion element 2 on the shell body 1, the periphery of shell body 1 is located to spacing component 6 cover for it is spacing to the sliding handle, prevent that the sliding handle from dropping or shifting from expansion element 2, can also judge simultaneously that the needle targets in place, avoid the unstable of needle knife play needle length under the manual control.
The principle and the implementation mode of the present invention are explained by applying specific examples in the present specification, and the above descriptions of the examples are only used to help understanding the method and the core idea of the present invention; meanwhile, for the general technical personnel in the field, according to the idea of the present invention, there are changes in the concrete implementation and the application scope. In summary, the content of the present specification should not be construed as a limitation of the present invention.

Claims (8)

1. An expansion incision device, characterized by: including shell body, expanding element and cutting subassembly, expanding element locates shell body one end, and with the inside intercommunication of shell body, expanding element is used for boring into and expands the puncture route between the narrow section of bile pancreatic duct and the alimentary canal lumen, the lateral wall of shell body is equipped with the spout, the spout intercommunication shell body inner chamber and the external world, cut the subassembly including cutting sword and smooth handle, cutting sword is located in the shell body, smooth handle cover is located the shell body periphery, expanding element's one end is equipped with the intercommunicating pore, the intercommunicating pore intercommunication expanding element inner chamber and external, smooth handle can drive cutting sword is in the extending direction reciprocating motion of shell body, and make cutting sword passes through the intercommunicating pore stretches out the shell body.
2. The dilation incision device of claim 1, wherein: the shell body is a round pipe body, the expansion element is conical, the large end of the expansion element is fixedly connected with the shell body, and threads are arranged on the periphery of the expansion element.
3. The dilation incision device of claim 2, wherein: the length of the expansion element is 2-3 cm.
4. The dilation incision device of claim 1, wherein: an electric plug is arranged on the sliding handle, one end of the electric plug is used for being electrically connected with an external power supply device, the other end of the electric plug is fixedly connected with the incision knife and used for electrifying the incision knife, and the incision knife is a needle-shaped incision knife.
5. The dilation incision device of claim 1, wherein: the sliding handle comprises two circular rings and a connecting section, the connecting section is sleeved on the periphery of the outer shell, the two circular rings are fixed at two ends of the connecting section respectively, and the arrangement directions of the two circular rings are perpendicular to the length direction of the cutting knife.
6. The dilation incision device of claim 1, wherein: the one end of keeping away from on the shell body the extension element is equipped with the handle, the handle is the ring-type for the operator is handheld.
7. The dilation incision device of claim 1, wherein: the periphery of the outer shell is provided with scales for an operator to observe the length of the communicating hole extending out of the cutting knife.
8. The dilation incision device of claim 1, wherein: the sliding handle is arranged on the outer shell, and the sliding handle is arranged on the outer shell in a sleeved mode.
CN202021612053.6U 2020-08-06 2020-08-06 Expansion incision device Active CN212234669U (en)

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CN202021612053.6U CN212234669U (en) 2020-08-06 2020-08-06 Expansion incision device

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Application Number Priority Date Filing Date Title
CN202021612053.6U CN212234669U (en) 2020-08-06 2020-08-06 Expansion incision device

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Publication Number Publication Date
CN212234669U true CN212234669U (en) 2020-12-29

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Country Status (1)

Country Link
CN (1) CN212234669U (en)

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