CN215738846U - Ureteroscope sheath assembly - Google Patents

Abstract

The application provides a ureteroscope sheath assembly, which mainly comprises a sheath tube with a main cavity channel, a sheath core with a sheath core channel and a sheath mirror, wherein the sheath core and the sheath mirror can be combined to penetrate through the main cavity channel; or the sheath mirror can be independently arranged in the main cavity channel in a penetrating way so as to form a sheath core working channel for executing the water return operation in the main cavity channel; or the sheath core can be separately arranged in the main cavity channel in a penetrating way so as to form a sheath mirror working channel in the main cavity channel, one of the sheath mirror working channel or the sheath core channel can be used for executing water injection operation, and the other can be used for executing water return operation. Therefore, the stone removing operation method and the stone removing device have the advantages that different combinations among the sheath tube, the sheath core and the sheath mirror are utilized to be suitable for carrying out the stone removing operation in different stages, the complexity of the stone removing operation can be reduced, and the stone removing effect can be improved.

Description

Ureteroscope sheath assembly

Technical Field

The embodiment of the application relates to the technical field of medical equipment, in particular to a ureteroscope sheath assembly.

Background

A ureteroscope is a medical device that can be inserted from the external orifice of the urethra to reach the ureter or the kidney. Ureteroscopes are typically configured with illumination, and lithotripsy devices to provide a physician with a view of the interior of the ureter or kidney and directed clearance of stones therein during a procedure.

Generally, the ureteroscope is mainly classified into a hard scope and a soft scope, wherein the hard ureteroscope has high hardness, is difficult to bend, is suitable for straight line operation or small bending position operation, and has large application limitation, and the soft ureteroscope can be partially bent, so that the hard ureteroscope can reach a position which is difficult to reach, and the defect of the application of the hard ureteroscope is overcome.

The operation procedure of the endoscope for the traditional ureter soft lens operation substantially comprises the following steps: firstly, probing the ureter by using a ureteroscope and indwelling a guide wire; then, advancing the introducer sheath along the guidewire in a blind state to a predetermined location, e.g., below the ureteral renal pelvis junction (UPJ); then, the inner core is taken out, and the soft lens is pushed to the target position along the guide sheath to perform the stone removal process.

The technical problems existing in the prior art mainly comprise that: the ureter has a bending section and a narrow section, and the insertion of the guide sheath cannot be observed, so that the insertion operation of the guide sheath has perforation risk; in addition, the diameter of the body section of the insertion part of the existing ureter soft lens is larger than that of the bending part at the far end, so that the gap between the inner part of the guide sheath and the ureter soft lens is small, and the problem of insufficient backwater space in the stone breaking process is caused. Moreover, in the existing stone removing operation, the distance between the perfusion channel and the suction channel is far, so that circulation cannot be formed in time, and the crushed stone discharging efficiency is influenced.

SUMMERY OF THE UTILITY MODEL

In view of the above problems, the present application provides a ureteral sheath mirror assembly and a stone removing method thereof, which can reduce the complexity of stone removing operation and improve stone removing effect.

The present application provides in a first aspect a ureteral sheath mirror assembly comprising: a sheath having a main lumen; a sheath core having a sheath core channel; and a sheath mirror; the sheath core and the sheath mirror can be mutually combined and penetrate through the main cavity; the sheath mirror can be independently arranged in the main cavity channel in a penetrating way so as to form a sheath core working channel for executing water return operation in the main cavity channel; the sheath core can be independently arranged in the main cavity channel in a penetrating mode, so that a sheath mirror working channel is formed in the main cavity channel, water injection operation is performed through one of the sheath mirror working channel and the sheath core channel, and water return operation is performed through the other one of the sheath mirror working channel and the sheath core channel.

Optionally, the sheath comprises a sheath distal end having a first guide surface and a sheath proximal end opposite the sheath distal end; the sheath core comprises a sheath core distal end with a second guide surface and a sheath core proximal end opposite to the sheath core distal end, and the sheath core distal end can extend out of the sheath tube distal end and generate bending deformation; the sheath mirror comprises a sheath mirror distal end with a third guide surface and a sheath mirror proximal end opposite to the sheath mirror distal end, and the sheath mirror distal end can extend from the sheath tube distal end and generate bending deformation; when the sheath core and the sheath mirror are combined and arranged in the main cavity channel in a penetrating mode, the second guide surface at the distal end of the sheath core is exposed out of the distal end of the sheath tube, the third guide surface at the distal end of the sheath mirror is exposed out of the distal end of the sheath core, and the first guide surface, the second guide surface and the third guide surface can be mutually butted to form an integrated guide surface; wherein the first guide surface, the second guide surface, and the third guide surface include one of a slope and an arc surface.

Optionally, the sheath further comprises a guide movably disposed at the proximal end of the sheath; wherein the guide is rotatable circumferentially relative to the sheath to drive synchronous rotation of the sheath core and/or the sheath mirror relative to the sheath.

Optionally, the guiding element is in threaded connection or snap connection with the proximal end of the sheath.

Optionally, the guide further comprises: a sheath core cover with a cross section not smaller than that of the sheath core, which is used for blocking the sheath core working channel at the proximal end of the sheath tube and controlling the sheath mirror to rotate synchronously relative to the sheath tube by means of circumferential rotation of the guide piece relative to the sheath tube; a sheath cap having the same cross-section as the sheath for occluding the sheath working channel at the sheath proximal end for controlling the sheath core to rotate synchronously relative to the sheath by circumferential rotation of the guide relative to the sheath.

Optionally, the ureteroscope sheath assembly further comprises: a sheath core positioning structure, disposed on the proximal end of the sheath core and the guide, for providing axial positioning of the sheath core relative to the sheath, so as to adjust an exposed length of the distal end of the sheath core relative to the distal end of the sheath; the sheath mirror positioning structure is arranged on the proximal end of the sheath mirror and the guide piece respectively and used for providing axial positioning of the sheath mirror relative to the sheath tube so as to adjust the length of the exposed tube at the distal end of the sheath mirror relative to the distal end of the sheath tube.

Optionally, the sheath-core positioning structure comprises a sheath-core positioning groove arranged on the guide member and a plurality of sheath-core positioning protrusions arranged at the proximal end of the sheath core; the sheath mirror positioning structure comprises a sheath mirror positioning groove arranged on the guide piece and a plurality of sheath mirror positioning convex parts arranged at the proximal end of the sheath mirror.

Optionally, the sheath mirror comprises a sheath mirror bending section adjacent to the sheath mirror distal end and a sheath mirror penetrating section adjacent to the sheath mirror proximal end; the diameter of the section of the sheath mirror penetrating section is not larger than that of the section of the sheath mirror bending section; and when the sheath core withdraws from the main cavity, the sheath mirror bending section is exposed out of the distal end of the sheath tube, and the sheath mirror penetrating section is remained in the sheath tube, so that the cross section area of the sheath core working channel formed in the sheath tube is maximized.

Alternatively, the sheath-penetrating segment may be constructed of a single material or of a composite material, and different sections of the sheath-penetrating segment may have the same hardness or different hardnesses.

Optionally, the sheath-mirror curved segment comprises an active curved segment and a passive curved segment.

Optionally, the sheath mirror further comprises a traction member connected to the active bending section and extending along the axial direction of the sheath mirror to the proximal end of the sheath mirror, and a traction force can be applied to the active bending section via the traction member to generate bending deformation of the active bending section.

Optionally, the sheath core distal end may grip the sheath scope distal end; wherein the sheath core is drivable to move synchronously with respect to the sheath when the sheath mirror moves axially with respect to the sheath; alternatively, the sheath core distal end may be driven to simultaneously flex as the sheath scope distal end flexes.

Optionally, opposite sides of the outer sidewall of the sheath core may abut against the inner sidewall of the primary channel, so that after the sheath mirror is withdrawn from the primary channel, the outer sidewall of the sheath core may be maintained to be in close contact with the inner sidewall of the primary channel, so that the cross section of the sheath mirror working channel is substantially the same as the cross section of the sheath mirror.

Optionally, the sheath-core cross-section comprises one of a C-shape, an omega-shape; the cross section of the sheath mirror comprises one of a circle, an ellipse, a gourd shape and an 8 shape.

Optionally, the tube side of the sheath tube further includes a channel interface communicated with the main lumen, for providing a water injection device or a water drainage device externally connected to the sheath tube.

In a second aspect, the present application provides a method for removing calculus, which is applied to the ureteroscope sheath assembly of the first aspect, and comprises: the sheath core and the sheath lens in the ureteroscope sheath assembly are combined and penetrated in a main channel of a sheath tube, and the sheath core, the sheath lens and the sheath tube which are combined into a whole are conveyed to the junction of the renal pelvis of the ureter according to an intracavity image captured by the sheath lens in real time; removing the sheath core from the sheath tube to form a sheath core working channel in the sheath tube, performing lithotripsy treatment on the calculus in the kidney according to the intracavity image captured by the sheath mirror in real time, and performing water return operation by means of the sheath core working channel; inserting the sheath core into the sheath, positioning the sheath core to a target location within the kidney where the debris is located with the sheath scope, and removing the sheath scope from the sheath to form a sheath scope working channel in the sheath; performing a water injection operation with the sheath core to perform flushing for the crushed stone at the target position, and performing a water return operation with the sheath mirror working channel to discharge the crushed stone at the target position; and removing the ureteroscope sheath assembly.

According to the technical scheme, the ureteral sheath mirror assembly and the stone removing method thereof can form different working states through any combination of the sheath tube, the sheath core and the sheath mirror so as to be suitable for carrying out stone removing treatment operations at different stages, thereby reducing the complexity of the ureteral stone removing operation and facilitating smooth execution of the operation.

Moreover, by means of the integrated guide surface formed by the respective end guide surfaces of the sheath tube, the sheath core and the sheath mirror, the technical effect of safe and visible combination of the upper sheath can be realized, the gap between the sheath tube and the sheath mirror can be improved, the resistance in the process of endoscopic access can be reduced, and the damage of a ureteral mucosa caused by a ureteral sheath mirror assembly in the process of endoscopic access can be avoided.

In addition, because the section diameter that the sheath mirror in the sheath mirror worn to establish the section is not more than the section diameter of the crooked section of sheath mirror for withdraw the back from the main cavity way when the sheath core, through making the crooked section of sheath mirror expose in the sheath pipe distal end, and only leave that the sheath mirror wore to establish the section and wear to locate inside the sheath pipe, make the cross sectional area maximize of the sheath core working channel who forms in the sheath pipe, thereby improve the return water efficiency of stone processing operation, reduce renal pressure.

In addition, a through sheath core channel is arranged in the sheath core, so that after the sheath mirror is withdrawn from the sheath tube, the sheath core and the sheath mirror working channel are matched with each other to wash and discharge the gravels at the target position, and the occurrence probability of complications is reduced by improving the active water circulation of the gravels operation.

Drawings

In order to more clearly illustrate the embodiments of the present application or the technical solutions in the prior art, the drawings needed to be used in the description of the embodiments or the prior art will be briefly described below, it is obvious that the drawings in the following description are only some embodiments described in the embodiments of the present application, and other drawings can be obtained by those skilled in the art according to the drawings.

Fig. 1 is a perspective view of an exploded configuration of a ureteral sheath mirror assembly according to the present application.

Fig. 2 is a side view of the sheath assembly of the present application in an exploded configuration.

Fig. 3 is a schematic view of an embodiment of an operational state of a ureteral sheath mirror assembly according to the present application.

Fig. 4 is a partial structural schematic diagram of the working state shown in fig. 3.

Fig. 5 is a schematic cross-sectional view of the operation state shown in fig. 3.

Fig. 6 is a schematic view of another embodiment of a sheath assembly according to the present application in another operational state.

Fig. 7 is a schematic cross-sectional view CC of the operating state shown in fig. 6.

Fig. 8 is a schematic view of an embodiment of a further operational state of a ureteral sheath mirror assembly according to the present application.

Fig. 9 is a schematic cross-sectional view CC of the operating state shown in fig. 8.

Fig. 10 and 11 are partial schematic views of the guide of the ureteral sheath mirror assembly of the present application.

Fig. 12A and 12B are schematic views of another embodiment of a sheath-core of a ureteral sheath-mirror assembly of the present application.

Fig. 13A-13C are schematic cross-sectional views of different embodiments of a sheath mirror of a ureteral sheath mirror assembly of the present application.

Fig. 14A-14C are schematic cross-sectional views of different embodiments of the sheath-core of the ureteral sheath mirror assembly of the present application.

Fig. 15 to 18 are schematic diagrams of different processing stages of the method for removing stones according to the present application.

Element number

10: a ureteroscope sheath assembly;

20: a sheath tube;

20a,20 b: a segmented pipe body;

202: a main lumen;

204: a sheath-core working channel;

206: a sheath mirror working channel;

208: a sheath distal end;

210: a first guide surface;

212: a sheath proximal end;

214: a guide member;

216: a sheath core cover;

218: a sheath mirror cover;

220: an inner sidewall;

222: a channel interface;

30: a sheath core;

30a,30 b: an end side;

302: a sheath-core distal end;

304: a second guide surface;

306: a sheath-core proximal end;

308: an outer sidewall;

310: a sheath-core channel;

40: a sheath mirror;

402: a sheath scope distal end;

404: a third guide surface;

406: a sheath mirror proximal end;

408: a sheath mirror bending section;

410: a sheath mirror penetrating section;

412: actively bending the segments;

414: passively bending the segments;

416: a sheath mirror channel;

50: a guide surface;

60: a sheath-core positioning structure;

602: a sheath core positioning groove;

604: a sheath-core positioning protrusion;

62: a sheath mirror positioning structure;

622: a sheath mirror positioning groove;

624: a sheath positioning boss;

70: a straight wire;

80: a guide wire;

902: the external orifice of the urethra;

904: a ureter;

906: trigone area of bladder;

908: a uretero-renal pelvis junction (UPJ);

910: the calyx of the kidney.

Detailed Description

In order to make those skilled in the art better understand the technical solutions in the embodiments of the present application, the technical solutions in the embodiments of the present application will be described clearly and completely below with reference to the drawings in the embodiments of the present application, and it is obvious that the described embodiments are only a part of the embodiments of the present application, but not all embodiments. All other embodiments obtained by a person of ordinary skill in the art based on the embodiments in the present application shall fall within the scope of the protection of the embodiments in the present application.

The ureteroscope sheath assembly is mainly used for directional removal of calculus in ureter or kidney, and specifically can be used for entering a target position in kidney through a patient ureter in a visual state to establish an operation channel for performing a calculus removal operation.

The following further describes specific implementations of embodiments of the present application with reference to the drawings of the embodiments of the present application.

Referring to fig. 1, the ureteroscope sheath assembly 10 of the present application mainly includes a sheath tube 20, a sheath core 30 and a sheath mirror 40.

In the present embodiment, the sheath 20 has a main channel 202 axially extending through the sheath 20.

Optionally, the sheath 20 may include a sheath distal end 208 and a sheath proximal end 212 opposite the sheath distal end 208.

Optionally, the tube side of the sheath 20 may further include a channel interface 222 communicating with the main channel 202 for providing a water injection device or a water drainage device externally connected to the sheath 20.

Alternatively, the channel interface 222 may be fixedly connected to the sheath 20 by means of adhesive or heat fusion.

Alternatively, the sheath 20 may be a one-piece tube design, or may be formed by combining a plurality of segmented tubes (e.g., segmented tubes 20a,20b in fig. 2), which is not limited in this application.

In the present embodiment, sheath-core 30 has a sheath-core channel 310 that extends axially through sheath-core 30.

Optionally, sheath core 30 may include a sheath core distal end 302 and a sheath core proximal end 306 opposite sheath core distal end 302, and wherein sheath core distal end 302 may protrude from sheath distal end 208 and yield to the bending deformation.

In this embodiment, the sheath mirror 40 may include a sheath mirror distal end 402 and a sheath mirror proximal end 406 opposite the sheath mirror distal end 402, wherein the sheath mirror distal end 402 may extend from the sheath distal end 208 and be bent.

Furthermore, a camera module (not shown) can be disposed at the end of the sheath mirror 40 for capturing images of the lumen (e.g., ureter).

In addition, a sheath channel 416 may be formed along the axial direction of the sheath 40, which may be used to pass a guide wire for the ureteroscope sheath assembly 10 to travel along the extension direction of the guide wire and reach a target location within the patient (e.g., uretero-pyeloid junction (UPJ)).

It should be noted that the above structural design of the sheath mirror 40 is well known to those skilled in the art and is not the technical focus of the present application, and therefore, will not be described herein in detail.

The sheath core 30 and the sheath mirror 40 can be combined to be arranged in the main cavity 202 or independently arranged in the main cavity 202, so that the ureteroscope sheath assembly 10 can form different working states to be suitable for carrying out calculus removing operations at different stages.

In one embodiment, the sheath core 30 and the sheath 40 can be combined with each other and inserted into the sheath 20 for performing a delivery operation (referring to the state shown in fig. 3), wherein the sheath 40 is used for capturing image data of a patient's lumen (e.g., ureter) in real time during the delivery operation, thereby realizing a visual delivery operation, facilitating a doctor to observe a curve and a narrow section in the ureter, facilitating accurate pushing of the ureteroscope sheath assembly 10 to UPJ through the ureter, and avoiding the risk of perforation of the ureter during the delivery operation.

Alternatively, referring to fig. 4, the sheath distal end 208 of the sheath 20 may have a first guide surface 210, and the sheath core distal end 302 of the sheath core 30 may have a second guide surface 304; the sheath distal end 402 of the sheath mirror 40 may have a third guide surface 404.

When the sheath core 30 and the sheath mirror 40 are combined to be inserted into the main lumen 202 to perform a delivery operation, the second guiding surface 304 of the sheath core distal end 302 is exposed out of the sheath distal end 208, and the third guiding surface 404 of the sheath mirror distal end 402 is also exposed out of the sheath core distal end 302, so that the first guiding surface 210 of the sheath tube 20 is in a mutually abutting state with the second guiding surface 304 of the sheath core 30 and the third guiding surface 404 of the sheath mirror 40 to form the integrated guiding surface 50.

Alternatively, the first guide surface 210, the second guide surface 304, and the third guide surface 404 may be, for example, inclined surfaces as shown in the drawings, or may be designed as arc surfaces (not shown), which is not limited in the present application.

In summary, the present application utilizes the sheath core 30 to fill the gap between the sheath 20 and the sheath mirror 40, which can reduce the resistance in the process of the transportation operation, so that the sheath core 30 and the sheath mirror 40 can be stably positioned in the sheath 20 without slipping easily. In addition, the guiding surface 50 formed by the combination of the sheath tube 20, the sheath core 30 and the sheath mirror 40 can reduce the ascending resistance, facilitate the delivery of the ureteroscope sheath assembly 10 to the target site, such as the delivery of the ureteroscope sheath assembly 10 to the ureteral pelvis junction via the Ureter (UPJ), and avoid the damage to the ureteral mucosa caused by the tip of the ureteroscope sheath assembly 10 during the delivery process.

Alternatively, in the case where the sheath core 30 and the sheath mirror 40 are combined to be inserted into the main channel 202 of the sheath tube 20, the sheath core 30 and the sheath mirror 40 can perform the linkage action.

In one embodiment, sheath core distal end 302 of sheath core 30 can grip sheath mirror distal end 402 of sheath mirror 40, such that sheath core 30 (sheath core distal end 302) can be actuated in conjunction with actuation of sheath mirror 40 (sheath mirror distal end 402).

For example, when the sheath mirror 40 moves axially relative to the sheath 20, the sheath core 30 can be driven to move axially synchronously relative to the sheath 20.

For another example, where both the sheath-scope distal end 402 and the sheath-core distal end 302 are exposed at the sheath-tube distal end 208, the sheath-core distal end 302 may be driven to a similar or the same bending deformation as the sheath-scope distal end 402.

In the present embodiment, the sheath mirror bending section 408 of the sheath mirror 40 may include an active bending section 412 and a passive bending section 414 (refer to fig. 2).

Optionally, the sheath mirror 40 further comprises a pulling member (not shown) which is connectable to the actively bending section 412 of the sheath mirror 40 and extends in the axial direction of the sheath mirror 40 to the sheath mirror proximal end 406, via which a pulling force can be applied to the actively bending section 412 to generate an actively bending deformation of the actively bending section 412. The above structural design is a common technical means in the field, and is not the technical key point of the present application, so detailed description is not provided.

Furthermore, the passive bending section 414 of the sheath mirror 40 can be, for example, abutted against the inner wall of the organ, so that the passive bending section 414 can be passively bent and deformed by the abutment force applied to the passive bending section 414 by the inner wall of the organ.

In one embodiment, the sheath-core distal end 302 can be bent using a passive bending principle, i.e., the sheath-core distal end 302 is provided with a corresponding passive bending deformation according to the bending deformation degree of the sheath-mirror bending section 408 in a state where the sheath-core distal end 302 holds the sheath-mirror distal end 402.

In another embodiment, the sheath-core distal end 302 may also be bent using active bending principles.

For example, the sheath-core distal end 302 of the sheath core 30 may be pre-molded in a curved state, and the sheath-core distal end 302 may be rendered in a straight state by threading the straight wire 70 in the sheath core 30, and the sheath-core distal end 302 may be rendered in a curved state by withdrawing the straight wire 70 from the sheath core 30 (refer to fig. 12A and 12B).

As described above, since the end portion of the sheath mirror 40 (the sheath mirror distal end 402) is provided with the camera module capable of capturing the images in the cavity, the sheath core distal end 302 can be accurately positioned at the target position by the linkage design between the sheath mirror 40 and the sheath core 30, so as to improve the stone removing effect.

Alternatively, the cross-section of the sheath core 30 may have a C-shape (i.e. a semi-circular shape) as shown in FIG. 13A or an omega-shape as shown in FIGS. 13B and 13C, and correspondingly, the cross-section of the sheath mirror 40 may have a circular shape as shown in FIG. 14A, an oval shape as shown in FIG. 14B, or a gourd-shape as shown in FIG. 14C, but not limited thereto, and the cross-section of the sheath mirror 40 may have a 8-shape (not shown)

Alternatively, the sheath-core passage 310 in the sheath-core 30 may be designed in one (refer to fig. 13A) or more (refer to fig. 13B, fig. 13C).

By the structural design of the sheath mirror 40 and the sheath mirror 30, the sheath mirror 40 and the sheath core 30 can be combined into a whole by detachably clamping the two opposite sides of the sheath core 30 (for example, the end sides 30a and 30b of the sheath core 30) so as to realize the technical effect of linkage action of the sheath mirror 40 and the sheath core 30.

In one embodiment, the sheath mirror 40 can be separately inserted into the main channel 202 to form a sheath-core working channel 204 (shown in fig. 6 and 7) in the main channel 202 for performing a water return operation.

In this embodiment, the sheath mirror 40 may include a sheath mirror bending section 408 adjacent the sheath mirror distal end 402 and a sheath mirror passing section 410 adjacent the sheath mirror proximal end 406.

Wherein, the diameter of the section of the sheath mirror penetrating section 410 is not more than the diameter of the section of the sheath mirror bending section 408. Preferably, the cross-sectional diameter of the sheath penetrating section 410 may be smaller than the cross-sectional diameter of the sheath bending section 408.

Specifically, when the sheath core 30 is withdrawn from the main channel 202, the sheath mirror bending section 408 of the sheath mirror 40 is exposed out of the sheath distal end 208, and the sheath mirror penetrating section 410 of the sheath mirror 40 is left in the sheath tube 20 (i.e., in the state shown in fig. 6), in this state, the cross-sectional area of the sheath core working channel 204 formed in the sheath tube 20 can be maximized (i.e., the diameter ratio of the main channel 202 to the sheath mirror 40 is maximized), so as to increase the water return ratio for performing the water return operation by means of the sheath core working channel 204, thereby effectively reducing the pressure of the renal pelvis during the operation, and improving the operation safety.

Alternatively, the sheath-mirror-passing section 410 may be made of a single material or a composite material, so that different sections of the sheath-mirror-passing section 410 may have the same hardness or different hardnesses, for example, the opposite ends of the sheath-mirror-passing section 410 may have different hardnesses according to different material mixing ratios, thereby satisfying different operation requirements.

In one embodiment, the sheath core 30 can be separately inserted into the main channel 202 to form the sheath-mirror working channel 206 in the main channel 202, so as to perform a water injection operation through one of the sheath-mirror working channel 206 and the sheath-core channel 310, and to perform a water return operation through the other one of the sheath-mirror working channel 206 and the sheath-core channel 310. In this state, the sheath-scope working channel 206 and the sheath-core channel 310 can form a perfusion-suction circulatory system in the kidney, thereby improving lithotomy efficiency.

Furthermore, compared with the prior art, the separation distance between the sheath-scope working channel 206 and the sheath-core channel 310 is short, so that a circulation loop can be formed in time to further improve the crushed stone discharging effect.

In addition, during the operation, the sheath core 30 can be axially moved relative to the sheath 20 to adjust the exposed length of the sheath core distal end 30 relative to the sheath distal end 208, so that the sheath core distal end 30 is closer to the position of the crushed stone and is flushed and discharged, the crushed stone discharging effect can be further improved, and the occurrence probability of complications can be reduced.

In the present embodiment, the cross section of the main channel 202 may be circular, and the cross section of the sheath core 30 may be C-shaped or Ω -shaped, such that two opposite sides (e.g., end sides 30a,30b) of the outer sidewall 308 of the sheath core 30 may abut against the inner sidewall 220 of the main channel 202, so as to keep the outer sidewall of the sheath core 30 tightly attached to the inner sidewall 220 of the main channel 202 after the sheath mirror 40 is withdrawn from the main channel 202, and the cross section of the sheath mirror working channel 206 formed in the sheath tube 20 may be substantially the same as the cross section of the sheath mirror 40, thereby improving the stone removing effect.

Optionally, the sheath 20 further includes a guide 214 movably disposed at the sheath proximal end 212.

Wherein the guide 214 is circumferentially rotatable relative to the sheath 20 to drive the sheath core 30 and/or the sheath mirror 40 to synchronously rotate relative to the sheath 20.

Optionally, the guide 214 may be threaded (e.g., the embodiment shown in fig. 2) or snap-fit (not shown) with the sheath proximal end 212. However, the present application is not limited thereto, and other movable connection manners may be adopted, and only the guiding element 214 is provided to be able to rotate circumferentially relative to the sheath 20.

Specifically, referring to fig. 10 and 11, the guide 214 may include a sheath-core cover 216 and a sheath-scope cover 218.

Wherein the cross section of the sheath-core cover 216 is not smaller than the cross section of the sheath-core 30 (e.g. C-shape, Ω -shape, etc.), and is used to provide the sheath-core cover 216 to block the sheath-core working channel 204 at the sheath proximal end 212 after the sheath-core 30 is withdrawn from the main channel 202, in which state the sheath-core cover 216 can abut against the sheath proximal end 406, so that when the guide 214 is rotated circumferentially relative to the sheath 20 (i.e. the sheath-core cover 216 is rotated circumferentially relative to the sheath 20), the sheath 40 can be driven to rotate synchronously relative to the sheath 20 to adjust the circumferential positioning position of the sheath 40 relative to the sheath 20.

Further, the sheath cover 218 may have the same cross section as the sheath 40 (e.g., circular, oval, gourd-shaped, 8-shaped, etc.) for providing the sheath cover 218 to close the sheath working channel 206 at the sheath proximal end 212 after the sheath 40 is withdrawn from the main channel 202, in which state the sheath cover 218 may abut against the sheath core metal shield 212, so that when the guide 214 is rotated circumferentially with respect to the sheath 20 (i.e., the sheath cover 218 is rotated circumferentially with respect to the sheath 20), the sheath core 30 may be driven to rotate synchronously with respect to the sheath 20 to adjust the circumferentially positioned position of the sheath core 30 with respect to the sheath 20.

Optionally, the ureteroscope sheath assembly 10 further includes a sheath core positioning structure 60, which is disposed between the sheath core proximal end 306 and the guide 214, for providing axial positioning of the sheath core 30 relative to the sheath 20 to adjust the exposed length of the sheath core distal end 302 relative to the sheath distal end 208.

In this embodiment, the sheath-core positioning structure 60 may include a sheath-core positioning slot 602 disposed on the guide 214 and a plurality of sheath-core positioning protrusions 604 disposed on the sheath-core proximal end 306 (see fig. 10 and 11).

Specifically, each sheath-core positioning protrusion 604 may be disposed on a position-limiting bar fixed to the sheath-core proximal end 306, and the position-limiting bar may be disposed in the sheath-mirror positioning groove 622 and axially move relative to the sheath-mirror positioning groove 622, so as to allow the sheath-core positioning groove 602 and any one of the plurality of sheath-core positioning protrusions 604 to be positioned with respect to each other, thereby adjusting the axial positioning position of the sheath-core 30 relative to the sheath 20 and achieving the technical effect of adjusting the length of the sheath-core distal end 302 exposed to the sheath distal end 208.

Optionally, the ureteroscope sheath assembly 10 further includes a sheath positioning structure 62, disposed on the sheath proximal end 406 and the guide 214, respectively, for providing axial positioning of the sheath 40 relative to the sheath 20 to adjust the exposed tube length of the sheath distal end 402 relative to the sheath distal end 208.

In this embodiment, the sheath positioning structure 62 may include a sheath positioning groove 622 disposed on the guide 214 and a plurality of sheath positioning protrusions 624 disposed on the sheath proximal end 406 (see fig. 10 and 11).

Specifically, each of the sheath positioning protrusions 624 may be disposed on a position-limiting bar fixed to the sheath proximal end 406, and the position-limiting bar may be disposed in the sheath positioning groove 622 and axially move relative to the sheath positioning groove 622, so as to allow the sheath positioning groove 622 and any one of the plurality of sheath positioning protrusions 624 to be positioned with respect to each other, thereby adjusting the axial positioning position of the sheath 40 relative to the sheath 20 and achieving the technical effect of adjusting the length of the sheath distal end 402 exposed to the sheath distal end 208.

Furthermore, the present application also provides a method for removing stones, which will be described below with reference to the accompanying drawings for exemplary processing steps of the method for removing stones of the embodiment, and mainly includes the following steps:

step S1502, the position of the calculus is located.

Step S1504, the sheath 20, the sheath core 30 and the sheath mirror 40 are assembled to constitute a visualization guide sheath (as shown in fig. 3).

In this embodiment, the sheath core 20 and the sheath mirror 30 can be combined with each other to be inserted into the main channel 202 of the sheath tube 20.

In particular, the sheath 20, the sheath core 30, and the sheath mirror 40 in combination may form a guide surface 50 (see fig. 4) to facilitate the delivery operation.

Moreover, the sheath core 20 is used for filling the gap between the sheath mirror 30 and the sheath mirror 40, so that the ascending resistance in the conveying process can be reduced, and the sheath core 30 and the sheath mirror 40 can be stably positioned in the sheath tube 20 and are not easy to shift or slip.

Step S1506, providing the sheath tube 20, the sheath core 30 and the sheath mirror 40 assembled into a whole to be delivered to the uretero-renal pelvis junction in the patient along the extending direction of the guide wire (refer to fig. 15).

In this embodiment, the guide wire 80 pre-positioned in the patient can be inserted into the sheath channel 416 of the sheath mirror 40 (refer to fig. 5) or into the sheath-core channel 310 of the sheath-core 30 (not shown), so that the sheath 20, the sheath-core 30 and the sheath mirror 40, which are assembled into a whole, can be delivered into the patient along the extending direction of the guide wire 80.

Specifically, the sheath core 30, the sheath mirror 40, and the sheath tube 20, which are combined together, can be advanced stepwise under the guidance of the guidewire 80 from the intraluminal images captured in real time by the camera module of the sheath mirror 40 during delivery, through the ureteral 904 via the external urethral opening 902 to the trigone 906, and through the ureteral opening to the uretero-renal pelvis junction 908 (see fig. 16-17).

Therefore, the visible conveying operation can be realized, the advancing route of the ureteroscope sheath assembly 10 can be observed in real time according to the intracavity images captured by the sheath mirror 40 in real time, and the damage to the mucosa of the ureter 904 in the conveying process can be avoided by matching with the guide surface formed by the sheath tube 20, the sheath core 30 and the sheath mirror 40.

In step S1508, the sheath core 30 is removed from the sheath 20 to form the sheath core working channel 204 in the sheath 20.

Specifically, the guidewire 80 and sheath core 30 may be removed from the sheath 20.

In step S1510, a lithotripsy process is performed for stones within the kidney.

Specifically, the sheath mirror 40 can be further advanced into the kidney or renal calyx 910, and according to the intracavity image captured by the sheath mirror 40 in real time, lithotripsy can be performed on the calculus in the renal calyx 910 through the sheath mirror passage 416 of the sheath mirror 40 by using a laser fiber or the like, and during lithotripsy, a water return operation can be performed through the sheath core working passage 204 to reduce the internal pressure of the kidney.

In the present embodiment, since the sheath bending section 408 with a larger cross section in the sheath 40 completely extends out of the sheath distal end 208, and only the sheath penetrating section 410 with a smaller cross section is retained inside the sheath 20, the cross-sectional area of the sheath-core working channel 204 formed in the sheath 20 can be maximized, which is beneficial to improving the efficiency of water return treatment of the sheath-core working channel 204, reducing the pressure in the kidney, and reducing the occurrence of complications.

In step S1512, it is determined whether or not the calculus is completely pulverized, and if not, step S1514 is performed, and if so, step S1516 is performed.

Step S1514, a rock casing tool is put in to collect the crushed stone that is not powdered, and then step S1516 is performed.

In this embodiment, after the lithotripsy is completed, the laser fiber can be withdrawn, and the basket set stones are selected according to the size of the lithotripsy to perform the set-up operation on the non-powdered lithotripsy.

Step S1516, the sheath core is inserted and delivered to the target site.

In the present embodiment, the sheath core 30 is reinserted into the sheath tube 20, and the sheath core 30 is positioned to the target site of the crushed stone in the kidney by the sheath mirror 40.

Specifically, the sheath core distal end 302 of the sheath core 30 can clamp the sheath core distal end 402 of the sheath mirror 40, so that the sheath core 30 (the sheath core distal end 302) can be operated in a linkage manner along with the operation of the sheath mirror 40 (the sheath mirror distal end 402), and the sheath mirror distal end 402 can be controlled to generate bending deformation or move back and forth to be positioned at a target position where a gravel is located by means of an intracavity image captured by the mirror sheath 40 in real time, and the sheath core distal end 302 in linkage with the sheath core can also be accurately positioned at the target position.

And step S1518, withdrawing the sheath mirror.

Specifically, the sheath mirror 40 can be removed from the sheath 20 to form a sheath mirror working channel 206 in the sheath 20.

In step S1520, a priming washing operation is performed to discharge the powdered crushed stones (refer to fig. 18).

In the present embodiment, a water injection operation may be performed using the sheath-core passage 310 in the sheath core 30 to perform flushing for the crushed stone at the target location, and a water return operation may be performed using the sheath-scope working passage 206 in the sheath tube 20 to discharge the powdered crushed stone at the target location.

Specifically, a water injection device may be connected to the sheath-core proximal end 306 to fill the sheath-core channel 310 with liquid and to discharge water through the sheath-core distal end 302 to flush the powdered debris in the calyx 910 to the kidney, while a negative pressure suction device may be connected to the sheath proximal end 212 to discharge the powdered debris flushed to the kidney.

As described above, since the cross section of the main channel 202 can be circular, the cross section of the sheath core 30 can be C-shaped or Ω -shaped, so that two opposite sides (e.g., the end sides 30a,30b) of the outer sidewall 308 of the sheath core 30 can abut against the inner sidewall 220 of the main channel 202, so as to keep the outer sidewall of the sheath core 30 tightly attached to the inner sidewall of the main channel 202 after the sheath mirror 40 is withdrawn from the main channel 202, so that the cross section of the sheath mirror working channel 206 formed in the sheath tube 20 is substantially the same as the cross section of the sheath mirror 40, thereby ensuring smooth discharge of the powdered crushed stone through the sheath mirror working channel 206.

Furthermore, since the separation distance between the sheath-scope working channel 206 and the sheath-core channel 310 is short, a circulation loop can be formed in time to further improve the crushed stone discharging effect.

Preferably, during flushing, when the sheath-scope working channel 206 is stuck with debris, the guide 214 can be used to control the sheath-core 30 to rotate circumferentially relative to the sheath 20 or the sheath-core 30 to move axially relative to the sheath 20 to agitate the stuck debris, thereby increasing the flow rate through the sheath-scope working channel 206.

In another embodiment, a water injection operation may be performed using the sheath-scope working channel 206 in the sheath tube 20 to perform flushing for the crushed stone at the target location, and a water return operation may be performed using the sheath-core channel 310 in the sheath core 30 to discharge the crushed stone at the target location.

Step S1522, determine whether the stone removal result is acceptable.

In this embodiment, the sheath mirror 40 can be inserted into the sheath tube 20 again to detect the remaining state of the calculus in the kidney, so as to determine whether the calculus removal result is acceptable, if yes, step S1524 is performed, and if not, step S1520 is returned to.

Step S1524, the ureteroscope sheath assembly in the patient body is removed, and the stone removing operation is finished.

To sum up, ureteroscope sheath subassembly and clear stone method of this application mainly includes following advantage:

the ureteral calculus removing device can systematically remove ureteral calculus and kidney calculus, a safety guide wire is placed in a visible state, a sheath core is used for filling a gap between a sheath tube and a sheath mirror, the ascending resistance of a sheath assembly of the ureteral mirror can be reduced, damage to the ureter is avoided, and hard and soft mirror instruments do not need to be frequently replaced, so that the complexity of the calculus removing operation is simplified.

The diameter of the section of the sheath mirror penetrating section is not larger than that of the section of the sheath mirror bending section, so that the cross section area of a sheath core working channel formed in the sheath tube is maximized, the water return efficiency in the operation is improved, the pressure in the renal pelvis is reduced, and the operation safety is improved.

After the stone breaking is finished, liquid is filled into a sheath core channel of the sheath core to wash the powdered stone in the renal calyx, and the sheath mirror working channel is connected with the negative pressure suction device to form a filling-suction circulating system in the kidney, so that the stone cleaning efficiency is improved.

The guide piece is utilized to control the sheath core to axially move or circumferentially rotate relative to the sheath tube, so that the problem that the working channel of the sheath mirror is blocked by gravels can be effectively solved, and the circulation rate is improved.

Finally, it should be noted that: the above embodiments are only used for illustrating the technical solutions of the embodiments of the present application, and are not limited thereto; although the present application has been described in detail with reference to the foregoing embodiments, it should be understood by those of ordinary skill in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some technical features may be equivalently replaced; and such modifications or substitutions do not depart from the spirit and scope of the corresponding technical solutions in the embodiments of the present application.

Claims (15)

1. A ureteroscope sheath assembly, comprising:

a sheath having a main lumen;

a sheath core having a sheath core channel; and

a sheath mirror;

the sheath core and the sheath mirror can be mutually combined and penetrate through the main cavity;

the sheath mirror can be independently arranged in the main cavity channel in a penetrating way so as to form a sheath core working channel for executing water return operation in the main cavity channel;

the sheath core can be independently arranged in the main cavity channel in a penetrating mode, so that a sheath mirror working channel is formed in the main cavity channel, water injection operation is performed through one of the sheath mirror working channel and the sheath core channel, and water return operation is performed through the other one of the sheath mirror working channel and the sheath core channel.

2. The ureteroscope sheath assembly of claim 1,

the sheath comprises a sheath distal end having a first guide surface and a sheath proximal end opposite the sheath distal end;

the sheath core comprises a sheath core distal end with a second guide surface and a sheath core proximal end opposite to the sheath core distal end, and the sheath core distal end can extend out of the sheath tube distal end and generate bending deformation;

the sheath mirror comprises a sheath mirror distal end with a third guide surface and a sheath mirror proximal end opposite to the sheath mirror distal end, and the sheath mirror distal end can extend from the sheath tube distal end and generate bending deformation;

when the sheath core and the sheath mirror are combined and arranged in the main cavity channel in a penetrating mode, the second guide surface at the distal end of the sheath core is exposed out of the distal end of the sheath tube, the third guide surface at the distal end of the sheath mirror is exposed out of the distal end of the sheath core, and the first guide surface, the second guide surface and the third guide surface can be mutually butted to form an integrated guide surface;

wherein the first guide surface, the second guide surface, and the third guide surface include one of a slope and an arc surface.

3. The ureteroscope sheath assembly of claim 2, wherein the sheath further comprises a guide member movably disposed at the proximal end of the sheath;

wherein the guide is rotatable circumferentially relative to the sheath to drive synchronous rotation of the sheath core and/or the sheath mirror relative to the sheath.

4. The ureteroscope sheath assembly of claim 3, wherein the guide is threaded or snap-fit to the proximal sheath end.

5. The ureteroscope sheath assembly of claim 3, wherein the guide further comprises:

a sheath core cover with a cross section not smaller than that of the sheath core, which is used for blocking the sheath core working channel at the proximal end of the sheath tube and controlling the sheath mirror to rotate synchronously relative to the sheath tube by means of circumferential rotation of the guide piece relative to the sheath tube;

a sheath cap having the same cross-section as the sheath for occluding the sheath working channel at the sheath proximal end for controlling the sheath core to rotate synchronously relative to the sheath by circumferential rotation of the guide relative to the sheath.

6. The ureteroscope sheath assembly of claim 3, further comprising:

a sheath core positioning structure, disposed on the proximal end of the sheath core and the guide, for providing axial positioning of the sheath core relative to the sheath, so as to adjust an exposed length of the distal end of the sheath core relative to the distal end of the sheath;

the sheath mirror positioning structure is arranged on the proximal end of the sheath mirror and the guide piece respectively and used for providing axial positioning of the sheath mirror relative to the sheath tube so as to adjust the length of the exposed tube at the distal end of the sheath mirror relative to the distal end of the sheath tube.

7. The ureteroscope sheath assembly of claim 6,

the sheath core positioning structure comprises a sheath core positioning groove arranged on the guide piece and a plurality of sheath core positioning convex parts arranged at the proximal end of the sheath core;

the sheath mirror positioning structure comprises a sheath mirror positioning groove arranged on the guide piece and a plurality of sheath mirror positioning convex parts arranged at the proximal end of the sheath mirror.

8. The ureteroscope sheath assembly of claim 2, wherein the sheath comprises a sheath bending section adjacent the sheath distal end and a sheath penetrating section adjacent the sheath proximal end;

the diameter of the section of the sheath mirror penetrating section is not larger than that of the section of the sheath mirror bending section;

and when the sheath core withdraws from the main cavity, the sheath mirror bending section is exposed out of the distal end of the sheath tube, and the sheath mirror penetrating section is remained in the sheath tube, so that the cross section area of the sheath core working channel formed in the sheath tube is maximized.

9. The ureteroscope sheath assembly of claim 8, wherein the sheath penetrating segment may be composed of a single material or a composite material, and different sections of the sheath penetrating segment may have the same hardness or different hardnesses.

10. The ureteroscope sheath assembly of claim 8, wherein the sheath bend section comprises an active bend section and a passive bend section.

11. The ureteroscope sheath assembly according to claim 10, wherein the sheath further comprises a pulling member connected to the active bending section and extending in the axial direction of the sheath to the proximal end of the sheath, and wherein a pulling force can be applied to the active bending section via the pulling member to cause bending deformation of the active bending section.

12. The ureteroscope sheath assembly of claim 11, wherein the sheath core distal end may grip the sheath distal end;

wherein the sheath core is drivable to move synchronously with respect to the sheath when the sheath mirror moves axially with respect to the sheath;

alternatively, the sheath core distal end may be driven to simultaneously flex as the sheath scope distal end flexes.

13. The ureteroscope sheath assembly of claim 12, wherein opposite sides of the outer sidewall of the sheath core may abut the inner sidewall of the primary channel to hold the outer sidewall of the sheath core against the inner sidewall of the primary channel after withdrawal of the sheath from the primary channel such that the cross-section of the sheath working channel is substantially the same as the cross-section of the sheath.

14. The ureteroscope sheath assembly of claim 13,

the sheath core cross-section comprises one of a C-shape and an omega-shape;

the cross section of the sheath mirror comprises one of a circle, an ellipse, a gourd shape and an 8 shape.

15. The ureteroscope sheath assembly of claim 1, wherein the tube side of the sheath further comprises a channel interface in communication with the primary channel for providing water injection or drainage external to the sheath.

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