CN212438557U - 组合式宫腔镜器械操作推进器 - Google Patents

组合式宫腔镜器械操作推进器 Download PDF

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CN212438557U
CN212438557U CN202020812832.4U CN202020812832U CN212438557U CN 212438557 U CN212438557 U CN 212438557U CN 202020812832 U CN202020812832 U CN 202020812832U CN 212438557 U CN212438557 U CN 212438557U
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张重医
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Xi'an Zhongke Mingyi Medical Technology Co.,Ltd.
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Abstract

本实用新型公开了一种组合式宫腔镜器械操作推进器，包括可附着连接在宫腔镜镜体上的推进体，器械借助推进体上的护套可沿着已经进入宫腔的镜体顺利通过阴道、颈管这些盲区，并在送入子宫后可以进行连续、灵活的治疗操作。本实用新型利于医生快速、准确、无创的将治疗器械送入子宫，不仅降低治疗成本，而且可以达到良好的治疗效果。

Description

组合式宫腔镜器械操作推进器
技术领域
本实用新型涉及宫腔镜手术治疗系统，具体涉及一种附着在宫腔镜镜体上以辅助器械进入宫腔的装置。
背景技术
在宫腔镜治疗过程中，常用的电切镜和治疗镜及刨削系统，它们共同点是检查镜体及多个治疗器械包裹在一起，导致整个系统比较粗，往往需要扩宫到8mm以上，而且治疗操作的器械一般结构精细，往往价格较高、操作复杂耗时，导致采用这些系统的宫腔镜手术难以在门诊开展。
在宫腔镜检查过程中，即便发现宫腔内存在息肉、宫腔粘连、粘膜下肌瘤，但由于剪子、电切刀、电切环、电针、电凝棒等治疗器械单独并不容易通过阴道、颈管等盲区，对于医生进一步开展宫腔镜治疗提出了较高的技能要求。另外，由于电切刀、电切环、电针、电凝棒的质地脆，容易损坏；剪子的前端尖锐锋利，容易划伤阴道、颈管粘膜，使得在门诊广泛开展宫腔镜手术面临诸多限制因素。
中国专利CN201379632Y公开了一种宫腔手术器，将宫腔钳按照与宫腔镜可同步移动、同时可独立操作的方式构成系统。其可以确保器械的进入和操作都在宫腔镜监视之下，但在更换器械时需要将宫腔镜一并退出，导致整个治疗过程仍需较长的时间，且器械操作范围有限，导致宫腔镜视野频繁更换，降低操作的连续性，影响治疗效果。
发明内容
本实用新型的目的在于提供一种结构简单、使用方便的组合式宫腔镜器械操作推进器。
为实现上述目的，本实用新型采用了以下技术方案：
该推进器包括柱状推进体，所述柱状推进体的一侧表面上设置有用于与宫腔镜镜体侧壁嵌合的卡槽，柱状推进体的另一侧表面上设置有沿宫腔镜镜体轴向延伸的导向凸条，导向凸条上设置有护套，护套包括可以与导向凸条滑动配合的套体以及与该套体相连的驱动杆。
优选的，所述卡槽(具体指柱状推进体与宫腔镜镜体的接触面)的横向截面为弧状(弧度大于π，可以使柱状推进体稳固的附着在宫腔镜镜体上，避免柱状推进体脱落)。
优选的，所述护套还包括设置在套体内壁上的与导向凸条相连的滑轨(套体内除滑轨占据空间以外的部分用于容纳电切刀、电切环、电针、电凝棒及剪子的前端)，驱动杆的一端设置在滑轨的外壁面上。
优选的，所述套体前端(即靠近宫腔镜镜体前端的那一端)采用弧状或子弹头状外形(为了便于安装与导向凸条配合的滑轨及套体的滑动，套体在外形上保留了完整的子弹头回转体的一部分外周，弧状外形的套体也是如此)。
优选的，所述柱状推进体的长度小于宫腔镜镜体的长度，柱状推进体两端与宫腔镜镜体对应端(特别是前端，即检查影像采集端)的距离通过所述卡槽与宫腔镜镜体的相对滑动进行调整。
优选的，所述柱状推进体位于所述卡槽开口和导向凸条之间的表面部分向外凸出，且该凸出的表面部分分为沿柱状推进体纵向截面(以宫腔镜镜体轴向为纵向)对称分布的两段，其中每段向外凸出的表面的横向截面为弧状(共同构成了柱状推进体除了卡槽、导向凸条、端面外的剩余表面)。
优选的，所述推进器可以配合窥器使用，也可以不使用窥器；例如，所述宫腔镜镜体和柱状推进体及器械可以通过穿过窥器进入宫腔中，也可以采用阴道内镜技术，不使用窥器，直接进宫腔镜镜体，宫腔镜镜体进入宫腔后，再用柱状推进体将器械送入宫腔。
本实用新型的有益效果体现在：
本实用新型利用柱状推进体的卡槽可以将导向凸条沿宫腔镜镜体导入并固定在进入宫腔的通道内，结合护套的配合滑动，使得前端较为容易损坏或容易损伤通道周围组织的器械可以在无宫腔镜监视情况下快速、准确、无创的送入宫腔，且器械前端一旦进入宫腔镜监视区域(即可后撤或退出护套)，则可以由医生连续完成一定视野内不同角度和深浅位置(操作范围更大、灵活性更强)上的病灶(宫腔内存在的息肉、宫腔粘连、粘膜下肌瘤)的手术操作，使得治疗过程操作简单、不需要扩宫或扩宫尺寸减小，操作过程也更为安全，降低治疗费用和时间，减轻治疗痛苦程度，可以在门诊完成相应的手术操作。同时，本实用新型的推广应用还可以降低器械的成本费用(可以使用结构更为简单的器械，器械无需复杂精细的结构设计)。
进一步的，本实用新型中卡槽、位于导向凸条与卡槽之间的外凸表面、护套的套体外形均为没有棱角的曲面，使得推进器、器械沿宫腔镜镜体的进入过程较为平稳，避免了对宫腔等处正常组织的损伤。
附图说明
图1为实施例中的宫腔镜器械操作推进器的主视图；
图2为实施例中的宫腔镜器械操作推进器的仰视图；
图3为实施例中的宫腔镜器械操作推进器的横向截面(A-A)示意图；
图中：1为宫腔镜镜体，1-1为镜体的后端，1-2为镜体的前端，2为推进体，2-1为凸条，3为护套，3-1为操作杆。
具体实施方式
下面结合附图和实施例对本实用新型作进一步详细说明。
参见图1、图2及图3，本实用新型所述宫腔镜器械操作推进器包括一推进体2及一护套3，所述推进体2的一侧表面为内凹的大半圆柱面，形成推进体2的卡槽，推进体2通过卡槽可以可靠的附着在宫腔镜镜体1上，推进体2的另一侧表面(卡槽的背面)具有一凸条2-1，所述护套3具有采用子弹头状外形设计的套体，套体内除了预留了用于容纳剪子的尖锐前端及电切刀、电切环、电针、电凝棒等器械的容易损坏的前端的空间外，还具有固定于套体内壁的滑轨(可采用凸槽式)，凸条2-1嵌入在滑轨内并可以相对滑动(沿宫腔镜镜体轴向)，套体的前后滑动由一操作杆3-1驱动，操作杆3-1的一端固定在滑轨外侧壁面上(不影响滑轨与凸条的配合滑动)，另一端向着宫腔镜镜体的后端1-1伸出套体(长度以方便握持操作为宜)；推进体2位于卡槽开口和凸条2-1对应侧之间的表面部分为向外凸出的弧状，可以减少与周围组织的碰擦，也可以将周围组织与凸条2-1进行一定的分隔，最大程度避免影响套体的滑动过程。推进体2长约115mm(宫腔镜镜体长度约为200mm)，套体长度约为15mm，二者均可用不锈钢材料加工成型，在推进体2卡在宫腔镜镜体1上后可以调整其前端与宫腔镜镜体的前端1-2的距离(例如，在宫腔镜监视区域观测到推进体2后)。推进体2的前端可加工成弧形，方便推进体2的移动(例如，减少与周围组织发生勾连、拖拽)，也可以减少对宫腔镜监视区域的遮挡(特别是推进体2前端接近镜体的前端1-2或与镜体的前端1-2位置重叠时)，使得在凸条2-1上滑动的护套3可以准确的定位，从而在器械移动中充分发挥保护作用。
宫腔镜手术操作时，将推进体2先通过其卡槽安装(压入或套入)在镜体的后端1-1，然后将宫腔镜镜体1送入子宫，在宫腔镜检查过程中，发现宫腔里有息肉、宫腔粘连、粘膜下肌瘤等情况时，就可以送入器械进行治疗操作，此时，依据宫颈内口的宽窄情况，将镜体的前端1-2停留在宫腔或者颈管内口处，将推进体2的前端推入到镜体的前端1-2，直至在宫腔镜的显示器上可以看到推进体2的前端时停止，可略微前后推拉，调整推进体2前端的位置(以确保护套3进入前及器械进入后，显示器上的宫腔镜监视区域视野始终保持良好)，将护套3的套体(通过滑轨)与凸条2-1连接，再将腹腔镜的剪子、电针、电切环等器械的前端放入套体内(需要用哪一种器械就将其放入套体)，利用操作杆3-1将套体推到镜体的前端1-2(一并推动器械)，直至在宫腔镜的显示器上看到套体的尾部，宫腔镜直视下从套体内移出剪子或者电针、电切环等器械，然后进行正常的治疗操作。需要更换治疗操作的器械时，将当前操作使用的器械退出(如果治疗中需要更换，比如剪子，在合拢后就可以直接取出，比如电针、电切环之类等不容易取出的，就可以放进套体，连同护套一起取出)，然后按照以上送入器械的方式重复进行，便可继续新的治疗操作。
由于宫腔镜检查过程中，发现宫腔里有息肉、宫腔粘连、粘膜下肌瘤，需要进入治疗器械，通过使用以上的推进器，这些器械在通过阴道、颈管这些盲区时，可以沿着已经进入的宫腔镜镜体1顺利送入(并退出)子宫，因此，可以缩短治疗操作之间的间隔时间，并且由于无需再使用将宫腔镜镜体和器械整合为一体的装置，仅需要宫口在6mm左右，使一些常规治疗基本不需要扩宫，可减轻病人的术中痛苦，避免住院治疗，同时，器械的操作受限较少，可以在显示器提供的宫腔镜视野下连续、灵活的操作，另外，还可以满足对治疗器械耐用、易得的客观需求，选择使用结构更为简单、尺寸更粗(使器械既容易操作，又不容易损坏)的治疗器械。
总之，本实用新型所述宫腔镜器械操作推进器利于医生快速、准确、无创的将治疗器械送入子宫，在门诊手术室即可完成治疗过程，不仅降低治疗成本，而且可以达到良好的治疗效果。

Claims (8)

1.一种组合式宫腔镜器械操作推进器，其特征在于：该推进器包括柱状推进体(2)，所述柱状推进体(2)的一侧表面上设置有用于与宫腔镜镜体(1)嵌合的卡槽，柱状推进体(2)的另一侧表面上设置有沿宫腔镜镜体(1)延伸的导向凸条(2-1)，导向凸条(2-1)上设置有护套(3)，护套(3)包括可以与导向凸条(2-1)滑动配合的套体以及与该套体相连的驱动杆。
2.根据权利要求1所述一种组合式宫腔镜器械操作推进器，其特征在于：所述卡槽的横向截面为弧状。
3.根据权利要求2所述一种组合式宫腔镜器械操作推进器，其特征在于：所述卡槽的弧度大于π。
4.根据权利要求1所述一种组合式宫腔镜器械操作推进器，其特征在于：所述护套(3)还包括设置在套体上的与导向凸条(2-1)相连的滑轨。
5.根据权利要求4所述一种组合式宫腔镜器械操作推进器，其特征在于：所述驱动杆的一端设置在滑轨的外壁面上。
6.根据权利要求1所述一种组合式宫腔镜器械操作推进器，其特征在于：所述套体具有弧状或子弹头状外形。
7.根据权利要求1所述一种组合式宫腔镜器械操作推进器，其特征在于：所述柱状推进体(2)的长度小于宫腔镜镜体(1)的长度，柱状推进体(2)两端与宫腔镜镜体(1)对应端的距离通过所述卡槽与宫腔镜镜体(1)的相对滑动进行调整。
8.根据权利要求1所述一种组合式宫腔镜器械操作推进器，其特征在于：所述柱状推进体(2)位于所述卡槽开口和导向凸条(2-1)之间的表面部分向外凸出，且该凸出的表面部分分为沿柱状推进体(2)纵向截面对称分布的两段，其中每段向外凸出的表面的横向截面为弧状。
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