CN215914508U

CN215914508U - Visual multi-functional ERCP intubate pipe

Info

Publication number: CN215914508U
Application number: CN202120282349.4U
Authority: CN
Inventors: 邢媛媛
Original assignee: Individual
Current assignee: Individual
Priority date: 2021-02-01
Filing date: 2021-02-01
Publication date: 2022-03-01
Anticipated expiration: 2031-02-01

Abstract

The utility model discloses a visual multifunctional ERCP intubation tube, which comprises an endoscope body, wherein an auxiliary tube which is in sliding connection with the endoscope body is arranged in the endoscope body, a guide wire which is in sliding connection with the auxiliary tube is arranged in the auxiliary tube, the head end of the guide wire can be inserted into a bile duct/pancreatic duct firstly and then guides the auxiliary tube to slide into the bile duct/pancreatic duct, and the guide wire is optical fiber. The catheter has the functions of an ERCP incision knife and an intubation tube of a contrast catheter, and can be inserted into the duodenal papilla through an endoscope instrument channel. The guide wire adopts optical fiber, can be selectively inserted into the catheter under direct vision, has a plurality of imaging modes, such as directly inputting white light for imaging, and can adopt other imaging modes when the white light cannot distinguish a front lumen, for example, fluorescent substances secreted by a bile duct/pancreatic duct can be intravenously injected into the human body or other animal bodies in advance, and then the catheter is assisted under the guidance of fluorescence by selecting the emitted light with specific wavelength and exciting the fluorescence.

Description

Visual multi-functional ERCP intubate pipe

Technical Field

The utility model relates to the technical field of bile duct and pancreatic duct endoscope interventional surgical instruments, in particular to a visual multifunctional ERCP intubation catheter.

Background

Endoscopic Retrograde Cholangiopancreatography (ERCP) is one of the major current minimally invasive methods for treating biliary pancreatic disease. The duodenoscope is inserted into the descending part of the duodenum through the mouth, and the ERCP special instrument is delivered into the bile duct or the pancreatic duct through the duodenal papilla through the duodenoscope instrument channel. Under X-ray fluoroscopy, contrast agent is injected for radiography, and instruments such as a lithotomy balloon, an expansion balloon, a cholepancreatic duct cytobrush, an oral choledochoscope, an ultrasonic in a cholepancreatic duct cavity, a metal stent, a plastic stent, a nasobiliary duct, a nasopancreatic duct and the like are introduced to finish diagnosis and treatment of the cholepancreatic diseases. On the basis of ERCP, the minimally invasive operations such as duodenal papillary sphincterotomy, cholepancreatic duct lithotomy, cholepancreatic duct tumor stent implantation drainage and the like can be performed. Because the operation is not performed and the wound is small, the hospitalization time is greatly shortened, and the traditional Chinese medicine is popular with patients.

In the ERCP operation, selective bile duct or pancreatic duct intubation is the key of the success or failure of the ERCP and is the technical difficulty. If intubation is unsuccessful, subsequent diagnosis and treatment cannot be performed. The failure rate of ERCP intubation caused by various reasons is high and can reach 5% -10% in experienced operators. Also, repeated attempts at intubation greatly increase the incidence of postoperative complications. How to improve the success rate of ERCP intubation, especially difficult intubation, is a focus of attention in the medical field at present. The ERCP intubation problem has become the largest 'road blocking stone' for carrying out ERCP diagnosis and treatment in primary hospitals.

The conventional bile-pancreatic duct intubation adopts a guide wire-assisted pull-type incision knife intubation method, namely, a pull-type incision knife with a hydrophilic ultra-smooth guide wire is inserted into the duodenal papilla opening through a duodenoscope instrument channel, the bile duct or pancreatic duct opening is successfully probed by using the guide wire under X-ray fluoroscopy, and then the incision knife is inserted into the bile duct or pancreatic duct along the guide wire. When the tube is inserted, the incision knife can only be roughly aligned to the direction of the bile duct or the pancreatic duct (the included angle between the entrance of the bile duct and the entrance of the pancreatic duct is 30 degrees), the tube cannot be inserted under direct vision, and when the tube is repeatedly tried, the papilla, the bile duct or the pancreatic duct can be damaged, and serious complications are caused.

SUMMERY OF THE UTILITY MODEL

It is an object of the present invention to overcome the above-mentioned deficiencies and to provide a visual multifunctional ERCP intubation catheter that solves at least one of the problems set forth in the background.

In order to achieve the technical purpose, the technical scheme of the utility model provides a visual multifunctional ERCP intubation tube, which comprises an endoscope body, wherein an auxiliary catheter which is in sliding connection with the endoscope body is arranged in the endoscope body, a guide wire which is in sliding connection with the auxiliary catheter is arranged in the auxiliary catheter, the head end of the guide wire can be inserted into a bile duct/pancreatic duct firstly and then guides the auxiliary catheter to slide into the bile duct/pancreatic duct, and the guide wire is optical fiber.

Furthermore, an outlet is formed in the outer peripheral surface of the head end of the endoscope body, and the head end of the auxiliary catheter can penetrate out of the outlet.

Furthermore, the visualized multifunctional ERCP intubation catheter also comprises an optical wave emission unit for inputting optical waves to the guide wire.

Further, the visualized multifunctional ERCP intubation catheter further comprises an optical wave receiving unit for receiving the optical wave reflected back by the guide wire.

Further, the endoscope body is a duodenoscope, a duodenoscope instrument channel is arranged on the duodenoscope, and the auxiliary guide pipe penetrates through the duodenoscope instrument channel in a sliding manner.

Furthermore, an auxiliary catheter water channel is arranged at the tail end of the auxiliary catheter, an auxiliary catheter instrument channel arranged along the length direction of the auxiliary catheter is further arranged in the auxiliary catheter, and the guide wire penetrates through the auxiliary catheter instrument channel.

Furthermore, the tail end of the optical fiber is provided with an incident light interface and a reflected light interface.

Further, the guide wire comprises an endoscope optical fiber and a lithotripsy optical fiber.

Compared with the prior art, the utility model has the beneficial effects that: the catheter has the functions of an ERCP incision knife and an intubation tube of a contrast catheter, and can be inserted into the duodenal papilla through an endoscope instrument channel. The core of the patent lies in that the guide wire adopts optical fiber, can be selectively inserted into the tube under the condition of direct vision, namely, a small endoscope is added on the basis of the original duodenoscope, the eyepiece at the end of the original duodenoscope is only used for finding the duodenal papilla in the duodenum, and then the guide wire made of the optical fiber is used for finding the bile duct or the pancreatic duct in the papilla. Specifically, the guide wire has multiple imaging modes, for example, white light can be directly input for imaging, when the white light cannot distinguish the front lumen, other imaging modes can be adopted, for example, fluorescent substances (such as indocyanine green and fluorescein sodium) secreted by the biliary tract can be intravenously injected in advance to be inserted into a human body or other animal bodies, (when bile duct/pancreatic duct is completely blocked and bile/pancreatic juice cannot be normally secreted, fluorescent substances can be reversely injected from bottom to top through the duodenal papilla) then, emitted light with specific wavelength is selected, fluorescence guide is carried out to assist intubation by exciting fluorescence, and the guide wire can also be converted into a treatment mode, and lithotripsy or radio frequency treatment is carried out by using a laser path optical fiber.

Drawings

FIG. 1 is a schematic diagram of the distribution structure in the bile duct and pancreatic duct;

FIG. 2 is a schematic structural view of a duodenoscope;

FIG. 3 is a schematic view of the trailing end structure of a multi-functional visual ERCP intubation catheter provided by the present invention;

FIG. 4 is a schematic structural view of a head end of a multi-functional visual ERCP intubation catheter provided by the present invention in a use state;

FIG. 5 is a schematic structural view illustrating a use state of the head end of the multifunctional ERCP intubation tube provided by the present invention when inserted into a duodenal papilla;

fig. 6 is a partially enlarged schematic view of a portion a in fig. 5.

FIG. 7 is a block diagram of a visualization of a multi-functional ERCP intubation catheter provided by the present invention;

FIG. 8 is a schematic cross-sectional view of one embodiment of a guidewire within a secondary catheter of the present invention;

FIG. 9 is a schematic view of a bend adjustment structure of the auxiliary conduit according to the present invention;

FIG. 10 is a schematic view of the distribution structure of an embodiment of the bend adjusting wire on the bend adjusting wire fixing member according to the present invention.

Detailed Description

In order to make the objects, technical solutions and advantages of the present invention more apparent, the present invention is described in further detail below with reference to the accompanying drawings and embodiments. It should be understood that the specific embodiments described herein are merely illustrative of the utility model and are not intended to limit the utility model.

It will be understood that when an element is referred to as being "secured to" another element, it can be directly on the other element or intervening elements may also be present. When an element is referred to as being "connected" to another element, it can be directly connected to the other element or intervening elements may also be present. The terms "vertical," "horizontal," "left," "right," and the like as used herein are for illustrative purposes only and do not represent the only embodiments.

Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. The terminology used in the description of the utility model herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the utility model. As used herein, the term "and/or" includes any and all combinations of one or more of the associated listed items.

Referring to fig. 1 to 10, the present embodiment provides a visual multifunctional ERCP intubation tube, including an endoscope body 1, an auxiliary catheter 2 slidably connected to the endoscope body is disposed in the endoscope body 1, a guide wire 3 slidably connected to the auxiliary catheter 2 is disposed in the auxiliary catheter 2, a head end of the guide wire 3 may be inserted into a bile duct a/a pancreatic duct b first, and then the auxiliary catheter 2 is guided to slide into the bile duct a/the pancreatic duct b, where the guide wire 3 is an optical fiber, and specifically, the guide wire 3 is an optical fiber bundle.

In this embodiment, the outer peripheral surface of the head end of the endoscope body 1 is provided with an outlet 11, and the head end of the auxiliary catheter 2 can pass through the outlet 11, so that the main nipple c can be conveniently found through the descending segment of the duodenum.

Further, the visual multifunctional ERCP intubation tube further includes a light wave emitting unit for inputting light waves to the guide wire 3, the visual multifunctional ERCP intubation tube further includes a light wave receiving unit for receiving the light waves reflected by the guide wire 3, and specifically, the tail end of the optical fiber is provided with an incident light interface 3a and a reflected light interface 3b for respectively connecting the light wave emitting unit and the light wave receiving unit.

The endoscope body 1 is a duodenoscope, the structure of the duodenoscope 1 is common knowledge in the field, and for the convenience of readers to understand the scheme, the structure of the duodenoscope 1 is described here simply: be provided with dodecarectoscope apparatus passageway 1a on the dodecarectoscope 1, supplementary pipe 2 slides and passes dodecarectoscope apparatus passageway 1a, the tail end of supplementary pipe 2 is provided with supplementary pipe water passageway 2a, still be provided with the edge in the supplementary pipe 2 supplementary pipe apparatus passageway 2b that 2 length direction of supplementary pipe arranged, 3 wear to establish of seal wire supplementary pipe apparatus passageway 2b, the tail end of optical fiber (bundle) is provided with incident light interface 3a and reflection light interface 3b, and how the input/output optic fibre of light wave belongs to field common general knowledge to do not belong to the utility model point of this patent, so do not do here and describe repeatedly.

The embodiment also provides a preferable embodiment, the guide wire 3 comprises an endoscope optical fiber 31 and a lithotripsy optical fiber 32, the endoscope optical fiber 31 and the lithotripsy optical fiber 32 are integrated side by side, the lithotripsy optical fiber 32 is connected to a laser output port of the holmium laser lithotripsy device through an optical fiber collimator, and the endoscope optical fiber 31 is connected to a CCD interface of an image processing system through another optical fiber collimator.

In a second embodiment, the endoscope optical fiber and the lithotripsy optical fiber are not integrated, after the endoscope optical fiber finds the lithotripsy position, the auxiliary catheter is guided to the lithotripsy position, then the endoscope optical fiber is pulled out, the inserted lithotripsy optical fiber is inserted into the auxiliary catheter, and laser lithotripsy is carried out.

In the third embodiment, two guide wire cavities are arranged in the auxiliary catheter 3, one guide wire cavity is used for guiding the endoscope optical fiber 31, the other guide wire cavity is used for guiding the lithotripsy optical fiber 32, and both the endoscope optical fiber 31 and the lithotripsy optical fiber 32 can independently slide relative to the auxiliary catheter 3.

The embodiment provides two bending adjusting modes of the head end of the auxiliary catheter 2:

the first is bidirectional bending: the auxiliary conduit comprises a bending adjusting wire fixing part, a bending adjusting hose and a bending adjusting pipe supporting part which are sequentially communicated, the bending adjusting wire fixing part, the bending adjusting hose and the bending adjusting pipe supporting part are all round pipes, the auxiliary conduit also comprises two bending adjusting wires, two fixing points are distributed on the bending adjusting wire fixing piece in the circumferential direction of 180 degrees, one ends of the two bending adjusting wires are fixedly connected with the two fixing points in a one-to-one correspondence mode, the other ends of the two bending adjusting wires extend to a rotating shaft in the bending adjusting handle, the winding directions of the two bending adjusting wires on the rotating shaft are opposite, one end of the rotating shaft is fixedly connected with an adjusting knob, the adjusting knob is rotatably connected with the bending adjusting handle, one bending adjusting wire can be recycled by rotating the adjusting knob, the other bending adjusting wire can be extended by rotating the adjusting knob, and the bidirectional bending of the bending adjusting wire fixing piece can be realized by rotating the adjusting knob in two directions.

The second is free direction bending: the auxiliary conduit 2 comprises a bending wire fixing part 201, a bending hose 202 and a bending pipe supporting part 203 which are sequentially communicated, the bending wire fixing part 201, the bending hose 202 and the bending pipe supporting part 203 are round pipes, the auxiliary conduit 2 further comprises four bending wires 204, four fixing points are distributed in 90-degree mode in the circumferential direction of the bending wire fixing part 201, one end of each of the four bending wires 204 corresponds to one of the four fixing points and is fixedly connected with the four fixing points, the other end of each of the four bending wires 204 extends into the bending handle 205, a rotating shaft and a rotating pipe which is sleeved on the rotating shaft are arranged in the bending handle 205, the length of the rotating shaft is larger than that of the rotating pipe, one end of the rotating shaft is fixed with a first bending knob 206, the other end of the rotating shaft penetrates through the rotating pipe and extends out of the rotating pipe, one end of the rotating pipe is fixedly connected with the first bending knob 206, the other ends of the two bending adjusting wires 204 are wound around the other end of the rotating shaft, the winding directions of the two bending adjusting wires 204 on the rotating shaft are opposite, the other ends of the two bending adjusting wires 204 are wound around the rotating tube, the winding directions of the two bending adjusting wires 204 on the rotating tube are opposite, one end of the rotating tube is fixedly connected with the second bending adjusting knob 207, the first bending adjusting knob 206 and the second bending adjusting knob 207 are rotatably connected with the bending adjusting handle 205, specifically, in this embodiment, the rotating shaft penetrates through a through hole in the second bending adjusting knob 207 and is fixedly connected with the first bending adjusting knob 206, and after the first bending adjusting knob 206 and the second bending adjusting knob 207 rotate, the traction forces of the four bending adjusting wires 204 on the bending adjusting wire fixing member 201 can be changed, and the traction forces of the bending adjusting wire fixing member 201 in four directions can be increased (the traction forces can be increased), Reducing) and simultaneously superposing, namely realizing universal adjustment, specifically, a hole cavity for accommodating the bending adjusting wire 204 is arranged in front of the inner circumferential surface and the outer circumferential surface of the bending adjusting pipe supporting part 203 along the length direction of the hole cavity.

The embodiment also needs to be explained as follows:

the embodiment also discloses an intubation method of the visual multifunctional ERCP intubation catheter, which comprises the following steps:

the method comprises the following steps: injecting fluorescent substances secreted by a bile duct or a pancreatic duct into a vein of a human body or other animals to be inserted, (for example, when the bile duct/pancreatic duct is completely blocked and bile/pancreatic juice cannot be normally secreted, the fluorescent substances can be injected reversely through a duodenal papilla from bottom to top);

step two: the incident light wave of the optical fiber excites the fluorescence to perform the auxiliary intubation under the fluorescence guidance.

The working principle is as follows: the catheter has the functions of an ERCP incision knife and an intubation tube of a contrast catheter, and can be inserted into the duodenal papilla through an endoscope instrument channel. The core of this patent lies in that the guide wire 3 adopts optical fiber, can carry out the selective intubate under looking directly, has increased a small endoscope on the basis of original duodenoscope equivalently, and the eyepiece of original duodenoscope head end is only used for finding the duodenal papilla in the duodenum, uses guide wire 3 that optical fiber made to find bile duct or pancreatic duct in the papilla afterwards. Specifically, the guide wire 3 has multiple imaging modes, for example, white light can be directly input for imaging, when the white light cannot distinguish the front lumen, other imaging modes can be adopted, for example, fluorescent substances secreted by the biliary tract can be intravenously injected in advance to be inserted into a human body or other animal bodies (in the case of complete obstruction of the bile duct/pancreatic duct and abnormal secretion of bile/pancreatic juice, the fluorescent substances can be reversely injected through the duodenal papilla from bottom to top), and then fluorescence guide is performed by selecting emission light with a specific wavelength and exciting fluorescence to assist intubation.

During specific operation, earlier with the endoscope through oral cavity, esophagus, gastric cavity, reach the descending part of duodenum, look for main nipple in the descending part of duodenum afterwards, send into auxiliary catheter 2 through endoscope apparatus channel, auxiliary catheter 2 inserts nipple c, adjusts and controls 2 head end directions of auxiliary catheter and depth of insertion through the crookedness of adjusting the mirror body and auxiliary catheter 2, switches different imaging mode, looks for lumen direction and bile pancreatic duct. If the front lumen can not be distinguished by white light, the fluorescent substance (such as indocyanine green and fluorescein sodium) secreted by the biliary tract can be injected into the vein of a patient (if the bile duct/pancreatic duct is completely obstructed and the bile/pancreatic juice can not be normally secreted, the fluorescent substance can be reversely injected through the duodenal papilla from bottom to top), the fluorescence is excited to conduct fluorescence guide and then the auxiliary intubation is conducted, after the auxiliary catheter enters the bile/pancreatic duct, different imaging modes can be converted, calculus and neoplastic lesion can be identified, if calculus or tumor is found, the treatment mode can be converted, and laser is utilized to carry out lithotripsy or radio frequency treatment.

The above-described embodiments of the present invention should not be construed as limiting the scope of the present invention. Any other corresponding changes and modifications made according to the technical idea of the present invention should be included in the protection scope of the claims of the present invention.

Claims

1. A visual multifunctional ERCP intubation tube comprises an endoscope body, wherein an auxiliary tube which is in sliding connection with the endoscope body is arranged in the endoscope body, a guide wire which is in sliding connection with the auxiliary tube is arranged in the auxiliary tube, the head end of the guide wire can be inserted into a bile duct/pancreatic duct firstly and then guides the auxiliary tube to slide into the bile duct/pancreatic duct, and the visual multifunctional ERCP intubation tube is characterized in that the guide wire is made of optical fibers.

2. The visual multifunctional ERCP intubation catheter according to claim 1, wherein a guide outlet is formed on an outer circumferential surface of the head end of the endoscope body, and the head end of the auxiliary catheter can pass through the guide outlet.

3. The visual multifunctional ERCP intubation catheter according to claim 1, wherein said visual multifunctional ERCP intubation catheter further comprises an optical wave emission unit for inputting optical waves to said guide wire.

4. The visual multifunctional ERCP intubation catheter according to claim 3, wherein said visual multifunctional ERCP intubation catheter further comprises a light wave receiving unit for receiving light waves reflected back from said guide wire.

5. The visual multifunctional ERCP intubation catheter according to claim 1, wherein the endoscope body is a duodenoscope having a duodenoscope instrument channel disposed thereon, and the auxiliary catheter slides through the duodenoscope instrument channel.

6. The visual multifunctional ERCP intubation catheter according to claim 5, wherein an auxiliary catheter water channel is provided at the tail end of the auxiliary catheter, an auxiliary catheter instrument channel is further provided in the auxiliary catheter along the length direction of the auxiliary catheter, and the guide wire passes through the auxiliary catheter instrument channel.

7. The multifunctional visual ERCP intubation catheter according to claim 1, wherein said optical fiber is provided with an incident light interface and a reflected light interface at the trailing end thereof.

8. The visual multifunctional ERCP intubation catheter according to claim 1, wherein said guide wire comprises an endoscopic fiber and a lithotripsy fiber.