CN215192016U

CN215192016U - Rotatable stone-taking basket with guide wire quick exchange device and balloon

Info

Publication number: CN215192016U
Application number: CN202121141400.6U
Authority: CN
Inventors: 程建平; 李雯; 沈永华
Original assignee: Nanjing Drum Tower Hospital
Current assignee: Nanjing Drum Tower Hospital
Priority date: 2021-05-26
Filing date: 2021-05-26
Publication date: 2021-12-17
Anticipated expiration: 2031-05-26

Abstract

The utility model relates to a rotatable stone-taking basket with a guide wire rapid exchange device and a balloon, which comprises an outer catheter and an inner catheter, wherein the inner catheter passes through the inner catheter, an operation cable passes through the inner catheter, the basket is arranged at one end of the operation cable, and the balloon is arranged at the outer edge of the outer catheter close to one end of the basket; along the extending direction of the outer catheter, two sides of the balloon are provided with contrast agent outlets; the basket is provided with a guide wire quick-switching device, and the guide wire passing through the guide wire quick-switching device can not only be used for quickly guiding the moving direction of the basket, but also be used for separating the accessory from the guide wire and keeping the guide wire in the bile duct. The basket can realize quick guide of accessories and quick separation of the guide wire through the quick guide wire exchange device, and can also realize the functions of positioning, blocking contrast agent and removing stones by utilizing the balloon.

Description

Rotatable stone-taking basket with guide wire quick exchange device and balloon

Technical Field

The utility model relates to the technical field of medical surgical instruments, specific rotatable calculus removing basket with a guide wire quick exchange device and a balloon.

Background

Common Bile Duct Stones (CBDS) are a common biliary disease that can cause abdominal pain, obstructive jaundice, cholangitis, and pancreatitis, and even death. With the continuous development of equipment and technology, endoscopic therapy has become the first treatment option for CBDS. By means of conventional Endoscopically Retrograde Cholangiopancreatography (ERCP) and endoendoscopic endoscopic inferior papillary myotomy (EST), the success rate of choledocholithiasis can reach 85-90%. Chinese endoscopic retrograde cholangiopancreatography guidelines (2018 edition) recommend that common bile duct stones can be removed using a balloon and basket.

The baskets are stronger and the pulling force stronger than the balloon, but due to structural reasons the baskets do not easily "grab" smaller stones and when the nipple is insufficiently cut or the stone is larger than expected, the basket retrieval may occasionally cause incarceration of the stone, which is more preferred in the united states in view of these disadvantages. One multicenter RCT study by Ozawa et al showed that the basket and balloon lithotomy methods had similar success rates for lithotomy (81.3% vs 83.9%, P = 0.7) at calculus diameters < 11 mm, with no statistical difference, and that the 2 methods had no statistical difference in post-operative complications such as hemorrhage, pancreatitis, cholangitis (6.6% vs 10.8%, P = 0.309). In yet another Ishi watari et al study, balloon lithotomy has higher total bile duct stone clearance than basket lithotomy (92.3% vs 80.0%, P = 0.037). Therefore, in actual operation, factors such as the size of the calculus and the experience of the operator need to be comprehensively considered, and the calculus removing method needs to be reasonably selected. In clinical practical application, especially after the common bile duct large calculus is broken, a saccule needs to be cleaned after the basket is frequently used for calculus removal, then whether the calculus is cleaned or not is confirmed by occlusion radiography, and the 2 accessories are frequently replaced back and forth in the calculus removal process, so that the operation time is increased, the pollution probability of the accessories in use is increased, and meanwhile, the cost of a patient is increased due to the 2 accessories.

When the calculus removing saccule is clinically used, a guide wire needs to pass through a 1.95-meter saccule cavity, the operation time is long, the problem of long guide wire exchange time can be effectively solved by using a quick exchange system, in the operation, calculus clinging to the wall of a choledocholithiasis can be extracted by a rotatable basket, and the functions cannot be integrated by related accessories seen in clinic at present.

Disclosure of Invention

The utility model provides a take rotatable stone basket of getting of seal wire quick switching device and sacculus, this kind of basket still include seal wire quick switching device and sacculus, can realize breaking away from fast of direction and seal wire through seal wire quick switching device, can also utilize the sacculus to realize location, separation contrast medium and get the function of stone.

In order to solve the technical problem, the utility model discloses a technical scheme does:

the utility model provides a take rotatable stone basket of getting of quick exchange device of seal wire and sacculus, includes outer pipe and inner catheter, and inside the inner catheter passed outer pipe, its characterized in that: the operation cable penetrates through the inner catheter, a basket is arranged at one end of the operation cable, and a balloon is arranged at the outer edge of one end, close to the basket, of the outer catheter;

along the extending direction of the outer catheter, two sides of the balloon are provided with contrast agent outlets;

be provided with the quick exchange device of seal wire on the basket, the seal wire passes the quick exchange device of seal wire and is used for guiding basket moving direction, and the quick exchange device of seal wire is used for breaking away from with the seal wire fast.

The guide wire rapid exchange device is of a hollow tubular structure, and any one net rope forming the net basket penetrates through the guide wire rapid exchange device.

The length of the guide wire rapid exchange device is not more than 5 mm.

The inner catheter is provided with a far-end contrast agent outlet at one end close to the basket, and a near-end contrast agent outlet is arranged at the joint of one side of the balloon far away from the basket and the outer catheter.

The distal contrast agent outlet is connected with a distal contrast agent injection tube, and the distal contrast agent injection tube passes through the inner catheter; the proximal contrast outlet is connected to a proximal contrast injection tube that passes through the outer catheter.

The saccule is communicated with one end of the saccule connecting cavity channel, and the saccule connecting cavity channel penetrates through the outer catheter.

The outer catheter is provided with a fixed cavity at one end far away from the basket, the inner catheter, the near-end contrast agent injection tube and the balloon connecting cavity channel penetrate through the fixed cavity, the fixed cavity is used for sealing the end part of the outer catheter, and the fixed cavity is also used for fixing the inner catheter, the near-end contrast agent injection tube and the balloon connecting cavity channel.

The maximum diameter of the balloon after expansion is 12-18 mm.

This take rotatable stone basket of getting of seal wire quick switching device and sacculus, the beneficial effect that can produce is: first, an operation cord is connected to the basket through the inner guide duct, and the basket can be controlled to be contracted and rotated by the operation cord.

The second, install the quick switching device of seal wire on the basket, the seal wire passes the quick switching device of seal wire and can make the accurate direction of basket remove to the target location, can take out fast away from the quick switching device of seal wire when the basket removes behind the target location, accomplishes breaking away from fast of seal wire, also can remain the seal wire in the courage pipe according to the demand simultaneously.

Thirdly, the balloon can realize the fixation of the end part of the outer catheter after being expanded and unfolded, and provides a foundation for the accurate operation of the basket; the balloon itself can also be used as a backup solution for stone removal.

Fourthly, contrast agent outlets are formed in the two sides of the balloon; the contrast agent is injected from the far-end contrast outlet, the contrast agent is contrasted from the far-end contrast outlet, the contrast of the common bile duct at the upper end of the opening, the intrahepatic bile duct and the whole common bile duct is displayed as the contrast agent is common in clinic, but the common bile duct is interrupted or the upper end of the common bile duct is very narrow, when the guide wire is difficult to pass through, the contrast agent is generally injected in large dose for the conventional contrast, the very narrow section cannot be displayed well or even cannot be displayed due to the natural channel of the opening of the nipple, and the guide wire can not be guided by a marking line.

Drawings

Fig. 1 is the structure schematic diagram of the rotatable stone-taking basket with the guide wire rapid exchange device and the balloon.

Fig. 2 is the utility model discloses a take seal wire quick switching device and sacculus rotatable get stone basket in seal wire quick switching device's structural schematic diagram.

The specification reference numbers: 1. an outer catheter; 2. a balloon; 3. an inner conduit; 4. a basket; 5. a guide wire rapid exchange device; 6. a distal contrast agent outlet; 7. a proximal contrast outlet; 8. operating a cable; 9. a distal contrast injection tube; 10. a proximal contrast injection tube; 11. the saccule is connected with the cavity channel; 12. a fixed cavity; 13. a guide wire; 14. a guidewire distal end.

Detailed Description

The invention is further described below with reference to the drawings and specific preferred embodiments.

As shown in figure 1, a rotatable calculus removing basket with a guide wire rapid exchange device and a balloon comprises an outer catheter 1 and an inner catheter 3, wherein the inner catheter 3 penetrates through the inside of the outer catheter 1, and the rotatable calculus removing basket is characterized in that: an operating cable 8 penetrates through the inner catheter 3, a basket 4 is arranged at one end of the operating cable 8, and a balloon 2 is arranged on the outer edge of one end, close to the basket 4, of the outer catheter 1;

along the extending direction of the outer catheter 1, two sides of the balloon 2 are provided with contrast agent outlets;

be provided with seal wire quick switching device 5 on the basket 4, the seal wire 13 passes seal wire quick switching device 5 and is used for guiding the basket 4 moving direction, and seal wire quick switching device 5 is used for breaking away from with seal wire 13 fast.

In the embodiment, the operation cable 8 penetrates through the inner catheter 3 and is connected with the inner catheter 3 in a sliding manner, and when the operation cable 8 is operated by the operation handle at the end part to slide along the axial direction of the inner catheter 3, the basket 4 can be driven to move telescopically; the operation rope 8 is operated by the operation handle at the end part to rotate 360 degrees, when the calculus clings to the wall of the bile duct, the operation rope 8 rotates to realize the rotation of the basket 4, so that the calculus clinging to the wall of the bile duct can be conveniently extracted.

In this embodiment, the guide wire fast exchanging device 5 is a hollow tubular structure, and any one of the net ropes forming the net basket 4 passes through the guide wire fast exchanging device 5.

Further, the length of the guide wire rapid exchange device 5 is not more than 5mm, and the axial length of the hollow tubular structure is generally 3 mm.

When the device is used, the guide wire 13 can rapidly penetrate through the guide wire rapid exchange device 5 and guide the basket 4 to move to a target position, and when the guide wire 13 needs to be separated from the guide wire rapid exchange device 5, the guide wire distal end 14 only needs to move for the length of the hollow tubular structure, so that the separation of the guide wire 13 and the guide wire rapid exchange device 5 can be realized. Compared with the conventional method of passing through an accessory cavity with the length of 1.95 meters, the method greatly shortens the time of the circulating guide wire 13 entering the total bile duct or intrahepatic bile duct.

In this embodiment, the balloon 2 is communicated with one end of the balloon connection channel 11, and the balloon connection channel 11 passes through the outer catheter 1. The expansion and contraction of the balloon 2 can be controlled by injecting or guiding a medium into or out of the balloon 2 through the balloon connection channel 11. The maximum diameter of the balloon 2 after expansion is 12-18 mm. Typically the maximum diameter of the balloon 2 after deployment is 15 mm.

The saccule 2 can be used for taking out calculus in a common bile duct or an intrahepatic bile duct after being expanded, or used for fixing the end part of the outer catheter 1, and certain stability is ensured when the basket 4 is adopted for calculus taking.

In this embodiment, a distal contrast outlet 6 is disposed at one end of the inner catheter 3 close to the basket 4, and a proximal contrast outlet 7 is disposed at a connection position of one side of the balloon 2 far from the basket 4 and the outer catheter 1. The distal contrast agent outlet 6 is connected with a distal contrast agent injection tube 9, and the distal contrast agent injection tube 9 passes through the inner catheter 3; the proximal contrast outlet 7 is connected to a proximal contrast injection tube 10, and the proximal contrast injection tube 10 passes through the outer catheter 1.

Furthermore, the distal end radiography outlet 6 injects the contrast medium, the contrast medium is subjected to radiography from the distal end radiography outlet, the radiography of the common bile duct at the upper end of the opening, the intrahepatic bile duct and the whole common bile duct is displayed as the same as the common clinical radiography, however, when the guide wire 13 needs to pass through the stenosis difficultly due to the interruption of the common bile duct or the very narrow section at the upper end, the conventional contrast generally needs a large dosage of contrast agent for injection, and the guide wire guidance of the marking line cannot be given because the natural channel of the nipple opening cannot be good or even cannot display the very narrow section, so that after the balloon 2 is opened, not only can realize the radiography of the upper section of the saccule 2 and display the narrow section, is beneficial to the guide of the guide wire 13, and contrast can be injected at the proximal contrast agent outlet 7, so that the contrast agent is prevented from entering when the contrast agent is not needed on the upper section of the balloon 2, particularly on the intrahepatic bile duct, the use of the contrast agent is reduced, and the risk of postoperative infection of a patient is reduced.

In this embodiment, a fixing cavity 12 is provided at one end of the outer catheter 1 away from the basket 4, the inner catheter 3, the proximal contrast injection tube 10 and the balloon connection cavity 11 all penetrate through the fixing cavity 12, the fixing cavity 12 is used for sealing the end of the outer catheter 1, and the fixing cavity 12 is also used for fixing the inner catheter 3, the proximal contrast injection tube 10 and the balloon connection cavity 11. The fixed inner catheter 3, the proximal contrast agent injection tube 10 and the balloon connecting cavity 11 are limited by a fixed cavity 12.

Furthermore, the injection end of the distal end contrast agent injection tube 9 is fixedly connected with the inner catheter 3 and used for limiting the distal end contrast agent injection tube 9, and the injection end of the balloon connecting cavity 11 is provided with a luer connector and is provided with a corresponding luer connector injector, so that the distal end contrast agent injection tube is not easy to fall off during operation.

Above only the utility model discloses an it is preferred embodiment, the utility model discloses a scope of protection not only limits in above-mentioned embodiment, and the all belongs to the utility model discloses a technical scheme under the thinking all belongs to the utility model discloses a scope of protection. It should be noted that, for those skilled in the art, a plurality of modifications and decorations without departing from the principle of the present invention should be considered as the protection scope of the present invention.

Claims

1. The utility model provides a rotatable calculus removal basket of quick exchange device of area seal wire and sacculus, includes outer pipe (1) and inner catheter (3), inside outer pipe (1) was passed in inner catheter (3), its characterized in that: an operating cable (8) penetrates through the inner catheter (3), a basket (4) is arranged at one end of the operating cable (8), and a balloon (2) is arranged at the outer edge of one end, close to the basket (4), of the outer catheter (1);

along the extension direction of the outer catheter (1), two sides of the balloon (2) are provided with contrast agent outlets;

be provided with seal wire quick switching device (5) on basket (4), seal wire (13) pass seal wire quick switching device (5) and are used for guiding basket (4) moving direction, and seal wire quick switching device (5) are used for breaking away from with seal wire (13) fast.

2. The rotatable calculus removal basket with a rapid guidewire exchange device and a balloon as claimed in claim 1, wherein: the guide wire rapid exchange device (5) is of a hollow tubular structure, and any one net rope forming the net basket (4) penetrates through the guide wire rapid exchange device (5).

3. The rotatable calculus removing basket with the rapid guidewire exchange device and the balloon as claimed in claim 2, wherein: the length of the guide wire rapid exchange device (5) is not more than 5 mm.

4. The rotatable calculus removal basket with a rapid guidewire exchange device and a balloon as claimed in claim 1, wherein: one end of the inner catheter (3) close to the basket (4) is provided with a far-end contrast agent outlet (6), and the joint of one side of the saccule (2) far away from the basket (4) and the outer catheter (1) is provided with a near-end contrast agent outlet (7).

5. The rotatable calculus removal basket with a rapid guidewire exchange device and a balloon as claimed in claim 4, wherein: the distal contrast agent outlet (6) is connected with a distal contrast agent injection tube (9), and the distal contrast agent injection tube (9) passes through the inner catheter (3); the proximal contrast outlet (7) is connected with a proximal contrast injection tube (10), and the proximal contrast injection tube (10) passes through the outer catheter (1).

6. The rotatable calculus removal basket with a rapid guidewire exchange device and a balloon as claimed in claim 5, wherein: the balloon (2) is communicated with one end of a balloon connecting cavity (11), and the balloon connecting cavity (11) penetrates through the outer catheter (1).

7. The rotatable calculus removal basket with a rapid guidewire exchange device and a balloon as claimed in claim 6, wherein: one end of the outer catheter (1), which is far away from the basket (4), is provided with a fixed cavity (12), the inner catheter (3), the near-end contrast agent injection tube (10) and the balloon connecting cavity (11) all penetrate through the fixed cavity (12), the fixed cavity (12) is used for sealing the end part of the outer catheter (1), and the fixed cavity (12) is also used for fixing the inner catheter (3), the near-end contrast agent injection tube (10) and the balloon connecting cavity (11).

8. The rotatable calculus removal basket with a rapid guidewire exchange device and a balloon as claimed in claim 6, wherein: the maximum diameter of the balloon (2) after expansion is 12-18 mm.