CN214511287U

CN214511287U - Electric cutting mirror, electric cutting mirror sheath and hole closing device

Info

Publication number: CN214511287U
Application number: CN202023238254.7U
Authority: CN
Inventors: 石广东; 吕春红; 孙建平; 许定珠
Original assignee: Taizhou Gaogang Hospital Of Traditional Chinese Medicine
Current assignee: Taizhou Gaogang Hospital Of Traditional Chinese Medicine
Priority date: 2020-12-29
Filing date: 2020-12-29
Publication date: 2021-10-29
Anticipated expiration: 2030-12-29

Abstract

An electric cutting scope, an electric cutting scope sheath and a hole closing device. The electric excision scope comprises a hole closing device, an outer sheath, an inner sheath, a working hand piece, an endoscope and an electric excision ring sleeved on the working hand piece, wherein the outer sheath comprises an outer sheath pipe, the near end of the outer sheath pipe is connected with an outer sheath pipe seat, a water outlet valve is arranged on the outer sheath pipe seat, the far end of the outer sheath pipe is provided with an extension pipe, an observation window is arranged on the extension pipe, and the observation window is started from the far end of the outer sheath pipe. The electric excision scope sheath comprises an outer sheath and an inner sheath, wherein the outer sheath comprises an outer sheath pipe, the near end of the outer sheath pipe is connected with an outer sheath pipe seat, a water outlet valve is arranged on the outer sheath pipe seat, the far end of the outer sheath pipe is connected with an extension pipe, an observation window is arranged on the extension pipe, and the observation window is positioned at the far end of the outer sheath pipe. The obturator includes a plunger for closing a viewing window in the outer sheath of the resectoscope sheath. The utility model discloses can eliminate urethra observation blind area and be applicable to the operation of pathological change within 3cm of external orifice near side of urethra.

Description

Electric cutting mirror, electric cutting mirror sheath and hole closing device

Technical Field

The utility model relates to a surgical instrument especially relates to an electricity that uropoiesis surgery used cuts mirror, electricity and cuts mirror sheath and obturator.

Background

The current resectoscope system for clinical urology comprises an outer sheath 1, an inner sheath 2, an obturator 9, an operating hand piece 3 and an endoscope 4 (fig. 1). The outer sheath tube of the outer sheath is 18cm long and round, and is usually F26, and the tail end of the outer sheath tube is provided with a plurality of rows of side holes with the length of about 28 mm; the inner sheath tube is about 2mm longer than the outer sheath tube, the tail end of the inner sheath tube is a high-temperature-resistant insulating porcelain head, and the body part of the inner sheath tube is slightly thin; after the inner sheath and the outer sheath are assembled, a small gap is formed between the two tubes and used as an outflow channel of flushing liquid, and the porcelain head of the inner sheath extends out by 2 mm. When the electric cutting endoscope sheath is used, the inner sheath is inserted into the outer sheath, then the obturator is inserted into the male urethra, after the electric cutting endoscope sheath is inserted into the male urethra to a certain depth, the obturator is pulled out, an operation system with an endoscope, an operation hand piece and an electric cutting ring is arranged, the operation system is connected with the light source and the washing pipeline, and at the moment, observation and operation operations can be carried out.

Clinically, the resectoscope system is mostly used for resecting prostatic hyperplasia tissues and bladder tumors in an electrically resected way, when the electrically resected urethra is diseased, as described above, referring to fig. 3, when the distal end of the resectoscope, namely the distal end of the resectoscope sheath, needs to be inserted into the urethra 6 for more than 3cm, an operator can hold the urethra and the entered sheath with the left hand and observe and treat the intra-urethral lesion at the distal end of the resectoscope through an endoscope in the resectoscope, and if the lesion is more than 3cm away from the external orifice of the urethra, the lesion A2 is positioned in front of the observation lens 41 of the resectoscope and is positioned in the visual field of the lens, the operator can observe the lesion and further perform an operation; if the distance between the lesion and the external orifice of the urethra is below 3cm, see fig. 3, the lesion A1 is located behind the lens of the observation mirror of the resectoscope, the lesion is not in the visual field of the lens, and the operator can not see the lesion and can not observe the lesion. Further analysis shows that the far end of the observation mirror is positioned at the tail end of the resectoscope sheath, the left hand of an operator can hold the urethra and the scope sheath inserted into the urethra to meet the requirements, the condition that the far end of the resectoscope sheath and the observation mirror are inserted into the urethra by more than 3cm is the necessary condition for observation and resectioning, at the moment, a lesion area within 3cm from the near side of the male urethra external orifice is positioned in a blind area of the resectoscope behind the observation mirror and the resectioning ring, and the operator cannot observe, resectionize and cauterize lesions within 3cm near the urethra external orifice by means of the existing resectoscope; if the depth of inserting the distal end of the electric excision scope sheath and the observation mirror into the urethra is controlled below 3cm, see fig. 2, the lavage liquid can not be poured into the urethra at the moment, the sheath falls off due to the shallow insertion of the scope sheath, and the left hand of an operator can not hold the urethra and the entered scope sheath, so that the operation can not be carried out. In conclusion, the incidence of intraurethral lesions, particularly lesions within 3cm close to the external orifice of the urethra, is obviously increased, and the current clinical resectoscope cannot be used for observation, electrotomy and fulguration of lesions within 3cm close to the external orifice of the urethra.

Disclosure of Invention

The utility model provides a can eliminate urethra observation blind area and be applicable to the electric excision mirror, electric excision mirror sheath and obturator apart from the operation of urethra outer orifice near side within 3 cm.

The utility model discloses a following technical scheme solves above-mentioned technical problem:

an resectoscope, include: the device comprises a hole closing device, an outer sheath, an inner sheath capable of being inserted into or pulled out of the outer sheath, a working hand piece capable of being inserted into or pulled out of the inner sheath, an endoscope capable of being inserted into or pulled out of the working hand piece, and an electrotomy ring which is arranged on the working hand piece and can be inserted into or pulled out of the inner sheath along with the working hand piece, wherein the outer sheath comprises an outer sheath pipe, the near end of the outer sheath pipe is connected with an outer sheath pipe seat, a water outlet valve is arranged on the outer sheath pipe seat, the far end of the outer sheath pipe is provided with an extension pipe, an observation window is arranged on the extension pipe and is used as an observation window of the endoscope and a working cavity of the electrotomy ring, and an insulating layer is arranged on the inner wall of the observation window section of the extension pipe.

An electric excision mirror sheath, include: the sheath comprises a sheath tube, the near end of the sheath tube is connected with a sheath tube seat, the sheath tube seat is provided with a water outlet valve, the far end of the sheath tube is connected with an extension tube, and the extension tube is provided with an observation window.

A with the hole ware that closes of supporting use of resectoscope, include: and the plunger is used for closing the observation window on the sheath of the electric cutting mirror sheath and is matched with the tail end after the obturator is inserted into the electric cutting mirror sheath.

Compared with the prior art, the utility model discloses following beneficial effect has:

the utility model discloses key improvement part to the resectoscope lies in the epitheca of resectoscope sheath, promptly: referring to fig. 5, an extension tube 14 of a sheath tube is added on the currently used sheath, a small side hole on the existing sheath is eliminated, an observation window 15 is arranged on the extension tube, and an endoscope can observe lesions through the observation window to eliminate the observation blind area of the endoscope. Specifically, the method comprises the following steps:

the defect that the endoscope positioned at the tail end of the existing resectoscope sheath (outer sheath) cannot observe the lesion in the region which is 3cm away from the external urethral opening at the back when the endoscope cannot observe the lesion when the resectoscope sheath (outer sheath) is inserted into the external urethral opening for more than 3cm in order to meet the requirement that an operator can hold the urethra and the resectoscope sheath (outer sheath) by the existing equipment (see fig. 3) is overcome.

The main functions of the extension pipe 14 and the observation window 15 thereon are: the extension tube provides the holding part of the resectoscope for an operator to hold the resectoscope sheath (outer sheath) inserted into the urethra, and simultaneously causes the relative backward movement of the endoscope lens in the original position, so that the endoscope sheath inserted into the urethra can be held to meet the operation condition, and the endoscope lens can still be positioned near the external orifice of the urethra or even outside the external orifice of the urethra, thereby ensuring that the urethra area within 3cm away from the external orifice of the urethra is all within the visual field range of the endoscope (see figure 7). It is visible, the utility model discloses can realize eliminating the observation blind area or the operation blind area in the urethra when satisfying the operation condition.

Drawings

Fig. 1 is a schematic view of a conventional resectoscope structure.

Fig. 2 is a schematic view of the distal end of the urethra being observed, resected and cauterized using a conventional resectoscope.

FIG. 3 is another schematic view of the distal end of the urethra being observed, resected and cauterized using a conventional resectoscope inserted 3cm into the urethra.

Fig. 4 is a schematic structural view of the resectoscope of the present invention, wherein 9 is the obturator of the present invention.

Fig. 5 is a schematic view showing the structure of the sheath of the resectoscope of the present invention, wherein 7 is a mesh cover, and 71 is a mesh on the mesh cover.

Fig. 6 is a schematic view of the structure of the inner sheath of the resectoscope.

Figure 7 is a schematic view of the use of the resectoscope of the present invention for distal urethral observation.

Fig. 8 is a schematic view of the utility model of the electric excision scope used for fulgurating and electrically cutting the far-end lesion of urethra.

Detailed Description

The term "distal end", also called front end, refers to the end of the operator away from the operator during the observation and operation process using the resectoscope; the term "proximal end", also called the posterior end, refers to the end of the patient near the patient during the operation and observation using the resectoscope.

Example 1

An resectoscope, comprising: the endoscope comprises a obturator 9, an outer sheath 1, an inner sheath 2 which can be inserted into or pulled out of the outer sheath 1, a working hand piece 3 which can be inserted into or pulled out of the inner sheath 2, an endoscope 4 which can be inserted into or pulled out of the working hand piece 3, and an electrotomy ring 5 which is arranged on the working hand piece 3 and can be inserted into or pulled out of the inner sheath 2 along with the working hand piece, wherein the outer sheath 1 comprises an outer sheath tube 11, the outer sheath tube 11 is a section of common round tube, two ends of the outer sheath tube 11 are open and not closed, holes are not formed in the tube wall, an outer sheath tube base 12 is connected to the proximal end of the outer sheath tube 11, a water outlet valve 13 is arranged on the outer sheath tube base 12, an extension tube 14 is arranged at the distal end of the outer sheath tube 11, an observation window 15 is arranged on the extension tube 14, the observation window 15 is used as a working cavity of the endoscope 4 and the electrotomy ring 5, and an insulating layer 141 is arranged on the inner wall of the observation window section of the extension tube 14. In this embodiment, a mesh cover 7 is screwed on the distal end of the extension tube 14, the mesh cover 7 is used for collecting the electrically cut lesion tissue, the irrigation of irrigation liquid is not hindered, the lesion tissue such as tumor can be prevented from being flushed into and polluting other lower urinary tract cavities, and the observation window 15 starts at 2.2cm of the end of the resectoscope and ends at 5 cm. The resectoscope can be used for the treatment of distal pathological changes of female urethra equally, and the thickness of the sheath of the resectoscope is consistent with that of the sheath of the original resectoscope system, namely F26 # and the like usually.

The present embodiment is further explained below:

because the end of the resectoscope sheath that uses now is almost on the coplanar with the endoscope end, can't observe and handle apart from the pathological change within 3cm of urethra outer orifice (see fig. 2) when holding the glans penis and inserting the resectoscope sheath, for the convenience of gripping and do not influence operations such as observation, electrocut, under the condition that does not change former complete set structural design, the utility model discloses only design a novel resectoscope sheath specifically does: referring to fig. 5, the distal end of the sheath is extended by 5cm (including the mesh eyeshade), a 2.8cm long notch is formed on the tube wall of the 2.2-5cm section of the end of the sheath and serves as an observation window 15 for exposing the lesion to facilitate corresponding treatment, the insulating material 141 is lined on the inner wall of the 2.8cm long notch section, and a plurality of rows of side holes on the tube wall of the existing end of the sheath are eliminated (fig. 5). The extension tube with the observation window is connected to the front end (namely the far end) of the sheath tube, or the sheath tube is extended forward by a section, the extension tube and the sheath tube can be integrally formed to form an integral structure, because the extension tube is long enough (5 cm), referring to fig. 7, the far end of the resectoscope, namely the far end of the resectoscope sheath, is inserted into the urethra by more than 3cm, so that when an operator can hold the urethra and the resectoscope or the sheath at the same time, the part or the main part entering the urethra is only the extension tube, and the endoscope lens in the utility model can be positioned near the external orifice of the urethra when the resectoscope is inserted into position, referring to fig. 7, a lesion A1 within 3cm from the external orifice of the urethra can enter the visual field of the endoscope and can be clearly observed, and if the resectoscope sheath rotates for a circle, the full view of the urethral wall can be seen; referring to fig. 8, with the aid of an endoscope, an operator can electrocautery or electrocut a lesion a1 below the observation window within 3cm of the external urethral orifice using an electrocision ring. Therefore, the device is beneficial to observing and treating the intraurethral focus within 3cm from the external orifice of the urethra, and the insulating layer is lined on the inner wall of the sheath of the 2.8cm gap section, so that the safety in the electrostomy can be ensured.

Example 2

An resectoscope sheath comprising: the sheath comprises an outer sheath 1 and an inner sheath 2 which can be inserted into or pulled out from the outer sheath 1, wherein the outer sheath 1 comprises an outer sheath pipe 11, the near end of the outer sheath pipe 11 is connected with an outer sheath pipe seat 12, the outer sheath pipe seat 12 is provided with a water outlet valve 13, the far end of the outer sheath pipe 11 is connected with an extension pipe 14, and the extension pipe 14 is provided with an observation window 15. In this embodiment, the observation window 15 starts at 2.2cm of the end of the resectoscope and ends at 5cm, the inner sheath 2 (see fig. 6) includes an inner sheath tube 21, an inner sheath tube seat 22 is connected to the proximal end of the inner sheath tube 21, a water inlet valve 23 is arranged on the inner sheath tube seat 22, and a porcelain head 24 is arranged at the distal end of the inner sheath tube 21. An insulating layer 141 (see fig. 5) is arranged on the inner wall of the observation window section of the extension tube 14, the insulating layer starts at 2.2cm of the tail end of the sheath of the electric resectoscope and stops at 5cm, a mesh cover 7 is connected to the far end of the extension tube 14 in a threaded mode, and the mesh cover 7 is used for collecting lesion tissues generated by electric resections. Mesh cover 7 is detachable construction, long 2cm, wherein end 1cm is the mesh and is the smooth form in circle, do benefit to the resectoscope and insert the urethra, the pipe wall section medial surface of its inboard 1cm and the rotary joint department of resectoscope sheath is female screw (fig. 5), and the terminal 1cm department outer wall of resectoscope sheath is the male screw (fig. 5) that corresponds, but these two rotatable butt joint of structure dress, on 7 rotary joint dress of mesh cover before the resectoscope promptly, wash in being favorable to the art, collect and cut down the tissue, take off mesh cover 7 rotation after the electrosection operation, be convenient for take out and cut down the tissue and do the apparatus washing, do benefit to apparatus maintenance and maintenance.

Example 3

An obturator for use with the resectoscope, comprising: and the plunger 8 is used for closing the observation window 15 on the sheath of the electric cutting mirror sheath after the obturator is inserted into the sheath of the electric cutting mirror, and is matched with the tail end. The obturator, see fig. 4, is used to close a 2.8cm long notch in the wall of the outer sheath tube to avoid damaging the urethra during insertion.

Claims

1. An resectoscope, comprising: a hole closing device (9), an outer sheath (1), an inner sheath (2) which can be inserted into or pulled out from the outer sheath (1), a working hand piece (3) which can be inserted into or pulled out from the inner sheath (2), and an endoscope (4) which can be inserted into or pulled out from the working hand piece (3), and an electrotomy ring (5) which is arranged on the working hand piece (3) and can be inserted into or pulled out of the inner sheath (2) along with the working hand piece, the outer sheath (1) comprises an outer sheath tube (11), the near end of the sheath tube (11) is connected with a sheath tube seat (12), a water outlet valve (13) is arranged on the sheath tube seat (12), it is characterized in that the far end of the sheath tube (11) is provided with an extension tube (14), an observation window (15) is arranged on the extension tube (14), the observation window (15) is used as an observation window of the endoscope (4) and a working cavity of the electric excision ring (5), an insulating layer (141) is arranged on the inner wall of the observation window section of the extension pipe (14).

2. The resectoscope according to claim 1, wherein a mesh cover (7) is screwed on the distal end of the extension tube (14) and the mesh cover (7) is used for collecting lesion tissues generated by the resectoscope.

3. The resectoscope according to claim 1, wherein the viewing window (15) starts at 2.2cm and ends at 5cm of the resectoscope tip.

4. An resectoscope sheath comprising: the water inlet valve is characterized in that the far end of the outer sheath pipe (11) is connected with an extension pipe (14), and the extension pipe (14) is provided with an observation window (15).

5. An resectoscope sheath according to claim 4, wherein the inner sheath (2) comprises an inner sheath tube (21), an inner sheath tube holder (22) is connected to the proximal end of the inner sheath tube (21), and a water inlet valve (23) is arranged on the inner sheath tube holder (22).

6. An resectoscope sheath according to claim 5, wherein a porcelain head (24) is provided at the distal end of the inner sheath (21).

7. An resectoscope sheath according to claim 4, wherein a mesh cover (7) is screwed to the distal end of the extension tube (14) and the mesh cover (7) is used for collecting lesion tissues generated by resectoscope.

8. An electrosurgical sheath according to claim 4, wherein an insulating layer (141) is provided on the inner wall of the viewing window section of the extension tube (14).

9. An resectoscope sheath according to claim 4, wherein the viewing window (15) starts at 2.2cm and ends at 5cm of the resectoscope tip.

10. An obturator for use with the resectoscope of claim 1, comprising: the plunger (8) is characterized in that after the obturator is inserted into the sheath of the electric resectoscope, the plunger (8) closes an observation window (15) on the sheath of the electric resectoscope sheath and is matched with the tail end.