CN212521913U

CN212521913U - Gravel lead supporting catheter

Info

Publication number: CN212521913U
Application number: CN202021698507.6U
Authority: CN
Inventors: 张�诚; 杨玉龙
Original assignee: Shanghai East Hospital Tongji University Affiliated East Hospital
Current assignee: Shanghai East Hospital Tongji University Affiliated East Hospital
Priority date: 2020-08-14
Filing date: 2020-08-14
Publication date: 2021-02-12
Anticipated expiration: 2030-08-14

Abstract

The utility model provides a rubble wire supports pipe. The utility model discloses a first pipeline section, second pipeline section and the third pipeline section that communicate in proper order, the inside rubble wire passageway that is equipped with of pipe, the outside is equipped with the sacculus, and inside is equipped with for the inflated passageway of sacculus. In a working state, the first pipe section and the second pipe section enter a human body, and the third pipe section is positioned outside the human body. The utility model is arranged in the gallbladder main pipe through the ERCP channel; when the calculus is crossed and the saccule is filled, the small calculus in the common bile duct can be dragged into the duodenum through the common bile duct; when the choledocholithiasis is large, the head end of the implanted catheter is close to the choledocholithiasis, a lithotripsy lead is implanted through the catheter, the tail end of the lead is connected with a plasma, a microelectrode or a holmium laser lead, the head end electrode of the lead is close to the choledocholithiasis for lithotripsy, and the inflated balloon can drag large lithotripsy into the duodenum after the lithotripsy. Low cost and easy popularization.

Description

Gravel lead supporting catheter

Technical Field

The utility model relates to a bile duct disease medical instrument technical field especially relates to a rubble wire supports pipe.

Background

Common bile duct stones are common diseases and frequently encountered diseases in China, the stones block common bile ducts to induce complications such as acute cholangitis, obstructive jaundice and acute cholangiogenic pancreatitis, the symptoms such as shivering, fever, abdominal pain and jaundice appear, serious patients even cause shock, and long-term stone stimulation has the risk of bile duct cancer, so that the common bile duct stones are important diseases which harm human health. The treatment scheme of the choledocholithiasis comprises laparotomy biliary tract exploration calculus removal, laparoscopic biliary tract exploration calculus removal, Endoscopic Retrograde Cholangiopancreatography (ERCP) calculus removal, percutaneous transhepatobiliary Puncture (PTCD), fistula expansion, Percutaneous Transcholangioscopy (PTCS) calculus removal, PTCD-approach duodenal papillary balloon expansion cyst calculus removal and the like.

For patients who are old, have many basic diseases, have cardiopulmonary dysfunction and the like and are not suitable for general anesthesia biliary tract exploration surgery, ERCP calculus removal is mostly adopted, firstly, nipple sphincter incision and balloon dilatation are carried out, then, the calculus is dragged into common bile duct by using the calculus removal balloon, but for huge common bile duct calculus with the diameter of more than 1.5cm, the adopted ERCP assisted basket mechanical calculus removal or SpyGlass directly-viewed lithotripsy is adopted. The above-mentioned technology head end has the following disadvantages: 1. before the calculus is completely taken out, the risk of large incision of the sphincter papilla and large sacculus papilla expansion is high, and short-term complications such as papillary hemorrhage, acute pancreatitis and perforation and long-term complications such as reflux cholangitis, early recurrence of calculus and cholangitis are easy to occur in the perioperative period; 2. the large common bile duct stones often cause obstruction of the common bile duct, and are difficult to be sleeved by a lithotripsy basket placed by the ERCP due to narrow space; 3. mechanical crushing efficiency of the basket is low, and part of hard cholesterol stones are difficult to be crushed by the basket; 4. if the calculus cannot be broken after being sleeved and taken, if the calculus cannot be discharged through the basket, the stone-breaking basket cannot be taken out, and only general anesthesia biliary tract exploration operation can be selected, so that the risk is high; 5. the ERCP is placed into the Spyglass to directly crush the stones, which is a new technology developed recently, the stone crushing efficiency is high, the complication is low, but the Spyglass instrument and the material consumption cost are extremely high, the technology is not developed in a common hospital, and a common family cannot bear the huge and high treatment cost.

SUMMERY OF THE UTILITY MODEL

In accordance with the above-mentioned technical problem, a lithotripsy wire support catheter is provided. The utility model discloses a technical means as follows:

a lithotripsy guide line supporting catheter comprises a first pipe section, a second pipe section and a third pipe section which are sequentially communicated,

the pipe body at the front end of the first pipe section is conical and provided with a cambered surface, the head end of the pipe body is spherical, and a first channel is arranged in the pipe body;

the second pipe section is a double-channel pipe, a balloon is arranged outside the second pipe section, a second channel in the double-channel pipe arranged inside the second pipe section is connected with the balloon, and a third channel is connected with the first channel;

the third pipe section is a double-channel pipe, a fourth channel in the double-channel pipe arranged in the third pipe section is communicated with the second channel, and a fifth channel is communicated with the third channel;

the second channel and the fourth channel are balloon inflation channels, and the first channel, the third channel and the fifth channel are lithotripsy lead channels;

in a working state, the first pipe section and the second pipe section enter a human body, and the third pipe section is positioned outside the human body.

Further, the surface of the first pipe section is coated with a hydrophilic coating.

Furthermore, the sacculus is cylindricality sacculus or spherical sacculus, and the top of sacculus does not exceed first pipeline section, the head end of second passageway is the cecum, and the bottom of fourth passageway links to each other with the gasbag joint.

Furthermore, the diameter of the saccule is 1.5-2.0 cm when the saccule is close to the tube wall of the first tube section, the diameter after inflation and expansion is 2.5-3.0 cm, and the length of the saccule is 1-3 cm.

Further, the gravel lead channel can contain gravel leads with the diameter of 2 mm.

Furthermore, a branch is arranged at the bottom end of the fifth channel and connected with a water injection joint on the side wall of the third pipe section.

Further, the outer diameter of the catheter comprises 8.5 Fr.

Furthermore, the total length of the conduit is 2.2-2.8 m.

Further, the outer wall of the third pipe section is also provided with a handle sleeve which is fixed on the outer wall of the third pipe section and is convenient to grasp.

The utility model has the advantages of it is following:

1. the front end pipe body of the utility model is conical, the head end of the pipe body is spherical, the surface is coated with a hydrophilic coating, and the pipe body can be more easily placed into the gallbladder main pipe through the duodenal papilla;

2. the head end of the utility model is provided with the saccule, which can directly drag the smaller choledocholithiasis into the duodenum;

3. the utility model can carry out plasma, microelectrode and laser lithotripsy on larger common bile duct calculi under X-ray through the lithotripsy lead, without the assistance of choledochoscope, and is more suitable for primary hospitals;

4. the head end of the utility model is provided with the saccule, and the pressure to the general wall of the gallbladder is generated after the saccule is filled, so that the displacement of the electrode can be prevented;

5. the utility model discloses the rubble electrode of putting into rubble wire passageway is located the central authorities of pipe and sacculus, can make the electrode keep away from the courage pipe wall behind the full sacculus, prevents that rubble in-process electrode from damaging the courage pipe wall.

6. The utility model discloses the distance between rubble wire and the calculus is adjustable, shortens the distance between rubble wire electrode and the calculus, multiplicable rubble effect.

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 description of the embodiments or the prior art are briefly introduced below, and it is obvious that the drawings in the following description are some embodiments of the present invention, and for those skilled in the art, other drawings can be obtained according to these drawings without inventive labor.

Fig. 1 is a schematic view of the specific structure of the present invention.

Fig. 2 is a cross-sectional view of the first pipe section (a) and the second pipe section (b), and (c) is a front sectional view of the first pipe section.

Fig. 3 is a schematic structural view of the cylindrical balloon when fully opened in the embodiment of the present invention.

Fig. 4(a) - (d) show four stages of the retrograde lithotripsy calculus removing process in example 1 of the present invention.

Fig. 5(a) - (d) show four stages of the retrograde lithotripsy calculus removing process in example 1 of the present invention.

In the figure: 1. a first tube section; 11. a first channel; 2. a second tube section; 21. a second channel; 22. a third channel; 3. a third tube section; 31. a fourth channel; 32. a fifth channel; 33. a handle cover; 34. a balloon inflation fitting; 35. and a liquid injection joint.

Detailed Description

In order to make the objects, technical solutions and advantages of the embodiments of the present invention clearer, the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present invention, and it is obvious that the described embodiments are some, but not all, embodiments of the present invention. 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.

As shown in fig. 1, fig. 2(a) (b) (c) and fig. 3, the present embodiment discloses a lithotripsy guide wire support catheter, which comprises a first pipe section 1, a second pipe section 2 and a third pipe section 3 which are communicated in sequence,

the front end of the first pipe section is conical and provided with a cambered surface, the head end of the pipe body is spherical, and a first channel 11 is arranged in the pipe body;

the second pipe section is a double-channel pipe, a balloon is arranged outside the second pipe section, a second channel 21 in the double-channel pipe arranged inside the second pipe section is connected with the balloon, and a third channel 22 is connected with the first channel;

the third pipe section is a double-channel pipe, a fourth channel 31 in the double-channel pipe arranged in the third pipe section is communicated with the second channel, and a fifth channel 32 is communicated with the third channel;

The surface of the first pipe section is coated with a hydrophilic coating.

The sacculus is cylindricality sacculus or spherical sacculus, and the top of sacculus does not exceed first pipeline section, the head end of second passageway is the cecum, and the bottom of fourth passageway links to each other with the gasbag joint.

The diameter of the saccule is 1.5-2.0 cm when the saccule is close to the tube wall of the first tube section, the diameter after inflation and expansion is 2.5-3.0 cm, and the length of the saccule is 1-3 cm.

The gravel lead channel can contain gravel leads with the diameter of 2 mm.

And a branch is arranged at the bottom end of the fifth channel and is connected with the water injection joint on the side wall of the third pipe section.

The outer diameter of the catheter included 8.5 Fr.

The outer wall of the third pipe section is also provided with a handle sleeve 33 which is fixed on the outer wall of the third pipe section and is convenient to grasp, and holes for installing a balloon inflation joint 34 and a liquid injection joint 35 can be formed in the handle sleeve.

Example 1

In this embodiment, the total length of the duct is 2.2 to 2.8 m.

The duodenoscope is placed through the mouth, after the bile duct is inserted successfully, an endoscope is firstly used for retrograde cholangiography to determine the number, the position and the size of calculus, then the duodenal papilla sphincter is slightly cut, and a cylindrical saccule with the diameter of 1.0cm is used for expanding the duodenal papilla.

As shown in fig. 5(a) to (d), the balloon catheter is inserted through the duodenal clip tract under the guidance of a guide wire, and the filled balloon drags the small calculi at the lower end of the common bile duct directly into the duodenum. When the calculus diameter exceeded 1cm, was close to the calculus with this sacculus pipe head end, was full of the sacculus and impels the sacculus to common bile duct distal end, and behind the calculus was pressed close to this sacculus pipe head end, it was full of the sacculus to common bile duct diameter and fixed sacculus, put into the rubble wire through rubble wire passageway, rubble wire head end electrode was close to behind the calculus of common bile duct, through plasma, microelectrode or laser rubble, hit the piece with the interior bold calculus of common bile duct.

After the calculus is broken, the balloon is released, the balloon catheter is placed above the crushed stone and inflated, and the crushed stone is dragged into the duodenum by using the inflated balloon.

Example 2

The PTCD is firstly used for draining bile to control biliary system infection and jaundice, and the PTCD tube is kept for 2 months.

The zebra guide wire is placed into the primary PTCD tube and passes through the duodenal papilla to enter the far end of the duodenum after the calculus is removed.

The guide wire is left and withdrawn from the original PTCD tube, the guide wire is placed into the guide wire through the head end of the catheter, as shown in figures 4(a) - (d), a lithotripsy catheter is sent into the biliary trunk under the guide of the guide wire, the size and the position of the calculus are displayed by injecting contrast through a water injection joint, and then the saccule is sent to the duodenal papilla. Injecting contrast agent through the balloon joint to perform duodenal papilla balloon dilatation, wherein the dilatation diameter is 0.8-1.2 cm.

And releasing the balloon, withdrawing the lithotripsy catheter to the proximal end of the common bile duct calculus, filling the balloon again, and pushing the diameter of the common bile duct calculus with the diameter of less than 1.0cm into the duodenum.

If the common bile duct calculi with the diameter larger than 1cm or smaller than 1cm can not pass through the nipples, normal saline is quickly instilled through the injection joint, the guide wire is withdrawn and the broken stone guide wire is arranged for plasma broken stones, large stones in the common bile duct are broken, and then the broken stones are pushed into duodenum by using the filled saccule.

After the lithotripsy is finished, injecting the contrast agent through the water injection hole again to determine that no calculus is left, releasing the balloon and withdrawing the contrast catheter.

Finally, it should be noted that: the above embodiments are only used to illustrate the technical solution of the present invention, and not to limit the same; although the present invention has been described in detail with reference to the foregoing embodiments, it should be understood by those skilled in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some or all of the technical features may be equivalently replaced; such modifications and substitutions do not depart from the spirit and scope of the present invention.

Claims

1. A lithotripsy guide wire supporting catheter is characterized by comprising a first tube section, a second tube section and a third tube section which are sequentially communicated,

2. The lithotripsy wire support catheter of claim 1, wherein the first tube segment surface is coated with a hydrophilic coating.

3. The lithotripsy guide wire support catheter of claim 1, wherein the balloon is a cylindrical balloon or a spherical balloon, the top end of the balloon does not exceed the first tube section, the head end of the second channel is a blind end, and the bottom end of the fourth channel is connected to the balloon connector.

4. The lithotripsy guide wire support catheter of claim 1 or 3, wherein the diameter of the balloon is 1.5-2.0 cm when the balloon is close to the wall of the first tube section, the diameter after inflation and expansion is 2.5-3.0 cm, and the length of the balloon is 1-3 cm.

5. The lithotripsy wire support catheter in accordance with claim 1, wherein the lithotripsy wire passage is configured to receive a lithotripsy wire having a diameter of 2 mm.

6. The lithotripsy wire support catheter of claim 1, wherein a branch is present at the bottom end of the fifth passageway and is connected to a water injection fitting on the side wall of the third section.

7. The lithotripsy wire support catheter of claim 1, wherein the outer diameter of the catheter comprises 8.5 Fr.

8. The lithotripsy wire support catheter of claim 1, wherein the catheter has a total length of 2.2-2.8 m.

9. The lithotripsy wire support catheter of claim 1, wherein the outer wall of the third tube segment is further provided with a grip sleeve secured thereto for easy grasping.