Ureter expansion sacculus seal wire
Technical Field
The utility model belongs to the technical field of medical equipment, more specifically relates to a ureter expansion sacculus seal wire.
Background
Ureteral stenosis refers to a condition in which a part or the whole of a lumen of a ureter is normally narrow due to various reasons, and the continuity of the lumen is not interrupted, but upper urinary tract obstruction and hydronephrosis are caused to different degrees. A true ureteral stenosis is a lesion that is clearly persistent and pathologic in the ureteral cavity, is fixed in location and never changes, and can be confirmed by endoureteric catheterization uretero-pyelography. It is clinically manifested as lumbago and swelling of waist on the affected side, aversion to cold, fever or purulent urine during concurrent infection, and uremia in bilateral stenosis. The treatment aims at recovering the continuity and the function of the ureter, eliminating obstruction, eradicating infection, saving and protecting kidney function. When angina is in attack, the symptoms should be relieved first, and then the treatment regimen should be selected.
Ureterectasis operation is suitable for ureteral stenosis caused by various reasons, such as stenosis caused by inflammation, stenosis caused by calculus, stenosis caused by iatrogenic injury, ureteral compression and metastatic stenosis caused by tumors of pelvic gynecology and the like. Under the anesthesia state, the ureteroscope enters the bladder from the urethra and then enters the ureter at the diseased side, and after reaching the narrow part, the specific opening condition of the narrow part is observed; and then placing an ultra-smooth guide wire into the narrow section, after the guide wire passes through the narrow section, entering the balloon along the guide wire for expansion, entering the lower part of the ureteroscope body along the guide wire for expansion, and remaining the ureteroscope stent for expansion, wherein the ureteroscope stent tube needs to be left after the expansion tube, the balloon and the ureteroscope body pass through the narrow section. The patient is pulled out in a period of 3 to 5 months after operation so as to achieve the effect of stabilizing the narrow section.
Ureteroscopy is a method for examining the renal pelvis, ureter, bladder and urethra for normality. The ureteroscope is a tubular instrument, enters the ureter from the urethra through the bladder, has a mirror surface at the front end, can transmit images to the other end through reflection or a light machine, and can observe the ureter structure and pathological changes through a ureteroscope window. The corresponding disease symptoms can be judged through the experiments. After anesthesia, the ureteroscope is put in through the urethra for examination and treatment, if tumors in the ureter or the renal pelvis exist, biopsy sampling can be carried out, and the tumors are burned off after being scraped; if the ureter is narrow, damaged and has more broken stones, a double J-shaped tube can be placed in the ureter to maintain the smoothness of the ureter, and the double J-shaped tube can be taken out after the condition of the patient is improved.
When the ureteroscope is difficult to advance, whether in ureterectasis surgery or ureteroscopy, the current technology is to open a passage for the advancement of the ureteroscope by placing a guide wire and further placing a balloon or other expansion device, however, the following problems exist in this way: 1. after the guide wire passes through, an expansion device is further placed, so that the size of the expansion device is larger than that of the guide wire, and the expansion device is not beneficial to the passing of a narrow position; 2. the inner cavity of the ureteroscope is required to be large enough to ensure that the ureteroscope can smoothly pass through an expansion device outside a guide wire; 3. the guide wire and the expansion device are both disposable, and at least one guide wire and one set of expansion device are needed in a single operation, so that the operation cost is increased.
SUMMERY OF THE UTILITY MODEL
In order to solve the defects in the prior art, the utility model aims to provide a ureteral dilatation balloon guide wire, when the balloon is in a contraction state, the equivalent diameter of the balloon part is close to that of the guide wire, and the whole device has better narrow part passing capacity like the guide wire; after the sacculus reachd the stenosis position, carry out the punching press expansion stenosis position to the sacculus through the inner chamber of the wire guide body of rod, can directly observe the result of expansion through the ureteroscope, guarantee that the ureteroscope passes through smoothly after further the pressure release.
The utility model adopts the following technical proposal. A ureteral dilation balloon guidewire, comprising: the joint, the stress buffer piece, the microtubule guide wire and the tip are sequentially connected; the saccule is connected with the far-end sleeve, and the saccule and the far-end sleeve are sleeved on the micro-tube guide wire; the microtubule guide wire is a metal microtubule, and one end connected with the end head is a rotary cutting section with a set length; the distal end sleeve is used for coating the rotary cutting section of the microtubule guide wire, and the length of the distal end sleeve is 10mm-100 mm.
Preferably, the rotary cutting section is a variable-pitch rotary cutting structure, and the pitch of the rotary cutting section gradually increases from one end of the microtubule guide wire connected with the tip to the other end of the rotary cutting section.
Preferably, the rotary-cut segment has a length of 10mm to 200mm and the rotary-cut pitch has a length of 0.5mm to 10 mm.
Preferably, the microtube guide wire is a stainless steel microtube or a nickel-titanium alloy microtube.
Preferably, the surface of the microcatheter guidewire includes a coating or coating.
Preferably, the microtubule guide wire is matched with a ureteroscope for use, and the outer diameter of the microtubule guide wire is 0.35mm-1.0 mm; the inner cavity of the microtubule guide wire is used for filling or withdrawing the saccule, and the inner diameter of the microtubule guide wire is 0.15mm-0.9 mm; the microtubule guide wire passes through the urethra, the bladder and the ureter, and the length of the microtubule guide wire is 400mm-2000 mm.
Preferably, the proximal end of the balloon is connected to the microcatheter guide wire at a location past the cut segment of the microcatheter guide wire and the distal end of the balloon is connected to the distal cannula.
Preferably, the middle part of the balloon is in the shape of a column, two ends of the middle part of the balloon are in the shape of a cone, the cone angle of the cones at the two ends of the balloon is 30-90 degrees, and the length of the middle column part of the balloon is 20-200 mm.
Preferably, the balloon has a pressure resistance of not less than 1.0 MPa.
The beneficial effects of the utility model reside in that, compared with the prior art, the utility model provides a when current ureter expansion operation or ureteroscope examination, need pass through the seal wire, further place the narrow rethread difficulty and the too high problem of operation cost of passing through difficulty, the size that is subject to the ureteroscope of the bigger expansion device of size that causes. The utility model provides a ureteral dilatation sacculus seal wire, when the sacculus is in the shrink state, the equivalent diameter of sacculus part is close with the seal wire, and the whole device is like the seal wire, has better narrow position throughput; after the sacculus reachd the stenosis position, carry out the punching press expansion stenosis position to the sacculus through the inner chamber of the wire guide body of rod, can directly observe the result of expansion through the ureteroscope, guarantee that the ureteroscope passes through smoothly after further the pressure release. Effectively reducing the operation cost.
Drawings
FIG. 1 is a schematic view of a balloon guidewire balloon in an expanded state;
FIG. 2 is an enlarged partial schematic view of a balloon guidewire;
FIG. 3 is a schematic view of a balloon guidewire balloon in a deflated state;
fig. 4 is a schematic diagram of the application of a balloon guidewire in ureter dilation surgery.
In the figure:
1-balloon guidewire;
11-a linker;
12-a stress buffer;
13-a microcatheter guidewire;
14-a balloon;
141-balloon proximal end;
142-a balloon distal end;
15 a distal cannula;
16-end head;
2-ureteroscope;
3-bladder;
4-ureter;
5-kidney.
Detailed Description
The present application is further described below with reference to the accompanying drawings. The following examples are only for illustrating the technical solutions of the present invention more clearly, and the protection scope of the present invention is not limited thereby.
As shown in fig. 1-3, the utility model provides a ureteral dilatation balloon seal wire 1, include: a joint 11, a stress buffer 12, a micro-tube guide wire 13, a balloon 14, a distal sleeve 15 and a tip 16. The joint 11, the stress buffer 12, the microtubule guide wire 13 and the tip 16 are connected in sequence; the sacculus 14 is connected with the far-end sleeve 15, and both the sacculus 14 and the far-end sleeve 15 are sleeved on the micro-tube guide wire 13.
The joint 11 is a luer joint, one end of the joint 11 can be connected with an external expansion device, and the other end of the joint 11 is connected with a stress buffering member 12, and the external expansion device is used for pressurizing and withdrawing the balloon 14.
The stress buffering member 12 is a flexible plastic tube and is used for buffering the stress of a stress concentration area at the connecting position of the joint 11 and the microtubule guide wire 13 and preventing the stress from being bent.
The micro-tube guide wire 13 is a thin and long metal micro-tube, and is required to have good toughness, be easy to pass through a bent narrow cavity in the pushing process and be not easy to bend.
It is understood that the microcatheter guidewire 13 needs to be in direct contact with human tissue, and the material of the microcatheter guidewire 13 is required to have good biocompatibility, and a preferred but non-limiting embodiment is a stainless steel microcatheter or a nitinol microcatheter. In a further preferred but non-limiting embodiment, in order to improve the biocompatibility of the micro-tube guide wire 13 or reduce the friction between the surface of the micro-tube guide wire 13 and the tissue, and improve the passing ability, the surface of the micro-tube guide wire 13 may be coated or coated.
It should be noted that, in order to improve the flexibility of the distal end of the microcatheter guidewire 13, that is, the end connected to the balloon 14, adopts a rotary-cut structure, the length of the rotary-cut segment is 10mm to 200mm, and the pitch of the rotary-cut line may be a constant pitch, but preferably a variable pitch, the pitch gradually increases from the most distal end of the microcatheter guidewire 13 to the nearest end of the rotary-cut segment, and the length of the rotary-cut pitch is 0.5mm to 10 mm.
Notably, the microcatheter guidewire 13 is required to be used in conjunction with the ureteroscope 2, a preferred but non-limiting embodiment being one having an outer diameter of 0.35mm to 1.0 mm; the lumen of the microcatheter guidewire 13 requires inflation or retraction of the balloon 14, a preferred but non-limiting embodiment being 0.15mm to 0.9mm in inside diameter; the microcatheter guidewire 13 is required to pass through the tissues of the urethra, bladder 3, ureter 4, etc., and in a preferred but non-limiting embodiment, has a length of 400mm to 2000 mm.
The proximal end 141 of the balloon is connected with the microtube guide wire 13, and the connection position is over the rotary cutting section of the microtube guide wire 13; the distal end 142 of the balloon is connected to the distal sleeve 15. The balloon 14 is used to dilate stenotic lesions, the middle part is in the shape of a cylinder with two ends in the shape of cones, the cone angle of the cones at the two ends of the balloon can be 10-170 degrees, and a preferred but non-limiting embodiment is 30-90 degrees. It will be appreciated that the taper angles at the ends may or may not be uniform. The length of the central cylindrical portion of the balloon is suitably 20mm to 200mm to completely cover the lesion.
The pressure resistance of the saccule is not lower than 1.0 MPa.
The distal sleeve 15 is used to cover the distal rotary cut of the microcatheter guidewire 13, and in a preferred but non-limiting embodiment, has a length of 10mm to 100 mm.
The tip 16 is used for sealing the far end of the balloon guide wire 1, and the front end face of the tip is a spherical surface, so that the tissue is prevented from being damaged when the balloon guide wire advances.
In order to further clearly describe the specific structure of the ureteral dilation balloon guide wire of the present invention, a specific method for using the ureteral dilation balloon guide wire is described below with reference to fig. 4. The using method comprises the following steps:
step 1, passing a ureteral dilatation balloon guide wire 1 through an inner cavity of a ureteroscope 2, wherein the head end of the balloon guide wire 1 is close to the head end of the ureteroscope 2.
Step 2, the ureteroscope 2 enters the bladder 3 along the urethra and the head end of the ureteroscope 2 is positioned at the entrance position of the ureter 4 through direct observation.
And 3, adjusting the head end of the balloon guide wire 1 to enter the orifice of the ureter, positioning the balloon 14 at the orifice of the ureter, connecting a balloon expansion device to the rear end connector of the balloon guide wire 1 to pressurize the balloon so as to expand the orifice of the ureter, and pumping back the balloon expansion device to negative pressure after expansion is completed so as to retract the balloon 14.
And 4, continuously advancing the balloon guide wire 1 forward towards the kidney 5 until the narrow section needing to be expanded is passed, enabling the balloon 14 to be positioned at the narrow section, and further advancing the ureteroscope along the balloon guide wire 1 to enter the ureter along the ureteral orifice and reach a position close to the narrow section.
And 5, pressurizing the balloon guide wire 1 again to expand the narrow position, and observing the expansion effect in real time through the ureteroscope 2.
Step 6, after the preset expansion time is reached, the balloon expansion device is pumped back to the negative pressure to enable the balloon 14 to retract again, the expansion effect is observed through the ureteroscope 2, if the expansion effect is satisfactory, the balloon guide wire 1 can be withdrawn, and the follow-up operation of the ureteroscope 2 is carried out; if the expansion effect is not satisfactory, the expansion process of the balloon 14 can be repeated until the satisfactory expansion effect is achieved.
The beneficial effects of the utility model reside in that, compared with the prior art, the utility model provides a when current ureter expansion operation or ureteroscope examination, need pass through the seal wire, further place the narrow rethread difficulty and the too high problem of operation cost of passing through difficulty, the size that is subject to the ureteroscope of the bigger expansion device of size that causes. The utility model provides a ureteral dilatation sacculus seal wire, when the sacculus is in the shrink state, the equivalent diameter of sacculus part is close with the seal wire, and the whole device is like the seal wire, has better narrow position throughput; after the sacculus reachd the stenosis position, carry out the punching press expansion stenosis position to the sacculus through the inner chamber of the wire guide body of rod, can directly observe the result of expansion through the ureteroscope, guarantee that the ureteroscope passes through smoothly after further the pressure release. Effectively reducing the operation cost.
The applicant of the present invention has made detailed description and description of the embodiments of the present invention with reference to the drawings, but those skilled in the art should understand that the above embodiments are only the preferred embodiments of the present invention, and the detailed description is only for helping the reader to better understand the spirit of the present invention, and not for the limitation of the protection scope of the present invention, on the contrary, any improvement or modification made based on the spirit of the present invention should fall within the protection scope of the present invention.