CN216602938U

CN216602938U - Bendable biopsy forceps with hollow forceps channel for real-time biopsy of lung lesion

Info

Publication number: CN216602938U
Application number: CN202121435843.6U
Authority: CN
Inventors: 侯刚; 杨汀; 王辰
Original assignee: China Japan Friendship Hospital
Current assignee: China Japan Friendship Hospital
Priority date: 2021-06-25
Filing date: 2021-06-25
Publication date: 2022-05-27
Anticipated expiration: 2031-06-25

Abstract

The utility model provides a bendable biopsy forceps with a hollow forceps channel for real-time biopsy of lung lesions, which comprises an insertion part, a biopsy forceps head and a biopsy forceps head, wherein the insertion part is provided with the hollow forceps channel and can accommodate a medical instrument for image navigation imaging to pass through; a forceps section provided at a distal end of the insertion section and including a first metal groove and a second metal groove capable of engaging with each other to form a space for accommodating a biopsy specimen, while forming an opening at a distal end to allow passage of the medical instrument; an operating portion provided at a proximal end of the insertion portion and connected to the grasping portion by a connecting means; the operating part can drive the first metal groove and the second metal groove to perform pivoting motion. The utility model can meet the requirement of real-time lung biopsy under the guidance of a radial bronchus ultrasonic or confocal laser endoscope probe, improve the diagnosis rate of peripheral lesion of the lung and avoid the exposure of radioactive rays of medical care workers and patients; providing high quality pathology/microbiology test samples for later treatment.

Description

Bendable biopsy forceps with hollow forceps channel for real-time biopsy of lung lesion

Technical Field

The utility model relates to a radial bronchus ultrasonic or confocal laser endoscope probe-guided real-time biopsy forceps for lung lesions, and belongs to the technical field of endoscope medical systems.

Background

The incidence of lung cancer is the first cause of death of men in China, and is the first cause of death of all large cancers. Accurate diagnosis of early stage lung cancer can enable more choices of treatment modes at later stage, and can also improve the 5-year survival rate of patients. Histopathological/cytopathological diagnosis after biopsy is the gold standard for early lung cancer diagnosis, while high quality biopsy tissue is the first choice for molecular biological diagnosis. Biopsy of lung peripheral lesion is usually percutaneous aspiration biopsy, image navigation biopsy, electromagnetic navigation biopsy. The diagnosis of the lung peripheral lesion by percutaneous aspiration lung biopsy needs to be operated under the exposure of radioactive rays, which brings radiation hazard to patients and workers and is easy to have complications such as pneumothorax, hemorrhage and the like. The existing navigation technology is fundamentally to construct a space coordinate system of a pulmonary nodule according to the reconstruction of a chest CT image, plan a reasonable path and then reach a focus part for biopsy, but CT data only represents the instantaneous space position condition of the scanning time point, and because a patient has respiratory motion during biopsy, the position of the pulmonary nodule is difficult to ensure to be consistent with the scanning time phase, and the existing research proves that the average displacement of the same nodule in an inspiratory phase and an expiratory phase can reach as much as 2 centimeters. Therefore, biopsy instantaneous X-ray localization confirmation is an independent factor that improves the diagnostic rate of guided lung nodule biopsy.

The diagnosis rate of the lung peripheral nodule of the single navigation technology is about 75%, and the diagnosis efficiency is still unsatisfactory without X-ray positioning; and the image processing host of the navigation technology is expensive. The position of lesion can be confirmed by the radial endobronchial ultrasonic probe, so that convenience is provided for biopsy of lung peripheral lesion, but assistance of a Guide Sheath (Guide Sheath) is often needed, the diagnosis rate is improved to a certain extent by adding the Guide Sheath, but the Guide Sheath is expensive, the radial endobronchial ultrasonic probe needs to be withdrawn in the operation process, and then the biopsy forceps are arranged, so that the risk of displacement is also caused, real-time visual biopsy cannot be realized, and the accuracy is reduced. Confocal laser microscopy endoscopes can reach the periphery of a lung through a sheath tube to determine whether nodules are good or malignant, but cannot replace pathological biopsy on the premise that the current lung cancer needs molecular biological diagnosis; the confocal laser micro-endoscope guided biopsy is similar to the radial endobronchial ultrasound, and a biopsy tool is placed after a confocal laser micro-endoscope probe is removed, so that the real-time visual biopsy cannot be realized.

SUMMERY OF THE UTILITY MODEL

In order to overcome the defects of radioactive ray exposure, navigation system positioning accuracy, displacement error generated when the radial endobronchial ultrasonic probe or confocal laser micro-endoscope probe is withdrawn and the like, the utility model aims to provide the bendable biopsy forceps with the hollow forceps channel, which is used for guiding the real-time biopsy of the lung focus by the radial endobronchial ultrasonic probe or the confocal laser micro-endoscope probe.

The technical scheme of the utility model is as follows.

A bendable biopsy forceps accompanied with a hollow forceps channel for real-time biopsy of lung lesions comprises

An insertion portion having a hollow jaw extending along an axis from a proximal end to a distal end, the hollow jaw capable of receiving a medical instrument therethrough for image guided imaging;

a grasping portion provided at a distal end of the insertion portion and including a first metal groove at an upper portion and a second metal groove at a lower portion; the first metal groove and the second metal groove can perform pivoting motion around a common pivot shaft and can be mutually meshed to form a space for accommodating a biopsy specimen, and an opening is formed at the far end; the opening is substantially equal in size to the cross section of the hollow cavity and is located on the axis to allow passage of the medical instrument;

an operating portion disposed at a proximal end of the insertion portion and connected to the grasping portion by a connecting means; the operating part can drive the first metal groove and the second metal groove to perform pivoting movement through the connecting device.

Preferably, the medical instrument is a radial bronchial ultrasound probe or a confocal laser endomicroscopy probe.

Preferably, the proximal opening of the hollow forceps channel is located at the side of the operating portion, and the distal opening is located at the root of the grasping portion.

Preferably, the first metal groove and the second metal groove have a cutting structure for clamping living tissue at the occlusion edges on both sides of the opening.

Preferably, the cutting structure comprises a blade disposed along the biting edge.

Preferably, the cutting structure comprises an alligator structure disposed along the biting edge.

Preferably, the connecting device is a push link structure, which is connected with the tail ends of the first jaw and the second jaw at the far end, and is connected with the pull ring of the operating part at the near end.

Preferably, the insertion portion comprises a substantially cylindrical flexible pincer body having an outer diameter of 1.8mm to 2.4 mm.

Preferably, the hollow forceps channel is positioned at the center of the flexible forceps body, and the inner diameter of the hollow forceps channel is 1.2mm-2.0 mm.

Preferably, the near end of the hollow forceps channel is provided with a luer connector, so that tools such as a small endobronchial ultrasound probe, a confocal laser micro-endoscope probe, an electromagnetic navigation positioning lead and the like can enter the front end of the biopsy forceps.

With the above technical solutions, the present invention can achieve the following technical effects.

1. The biopsy forceps provide possibility for real-time lung biopsy under the guidance of the radial bronchial ultrasound or confocal laser endoscope probe, and reduce errors caused by withdrawing the radial bronchial ultrasound or confocal laser endoscope probe and then entering the biopsy forceps; the utility model realizes real-time visual biopsy, improves the accuracy of peripheral pulmonary nodule biopsy compared with the prior navigation technology, and has the advantages that the pulmonary nodule coordinate system generated by the chest CT reconstruction based on the prior navigation technology is not real-time and synchronous with the biopsy time phase and is influenced by the displacement of pathological changes due to respiratory motion. Meanwhile, the risk of pneumothorax and hemorrhage can be reduced by biopsy in a natural cavity channel compared with percutaneous puncture biopsy; high quality tissue samples and bronchoalveolar lavage/irrigation fluid are provided for subsequent pathology/molecular biology diagnosis.

2. The biopsy forceps can perform real-time biopsy under the guidance of a probe of a radial bronchial ultrasound or confocal laser endoscope, and do not need additional X-rays for auxiliary positioning. Eliminates the radiation exposure harm of the majority of medical workers and patients, improves the operation experience of the operator without wearing a heavy forceps cover, reduces the fatigue of the operator, and further improves the accuracy of the biopsy operation.

3. The biopsy forceps disclosed by the utility model are simple in structure and feasible in processing technology. Compared with biopsy tools used in cooperation with bronchus navigation technology with price close to ten thousand yuan, the method has obvious price advantage, reduces the economic burden of patients, and simultaneously reduces the social burden of diagnosis of lung cancer and other lung peripheral lesions.

Drawings

FIG. 1 is a schematic diagram of the overall construction of a bioptome of the present invention;

FIG. 2 is a cross-sectional view of the overall construction of the bioptome of FIG. 1;

FIG. 3 is an enlarged sectional view of the jaw portion of the biopsy forceps shown in FIG. 1

FIG. 4 is a generally schematic view of the bioptome of FIG. 1 with the jaws open;

FIG. 5 is an enlarged fragmentary view of the bioptome of FIG. 1 with the jaws open;

FIG. 6 is a generally schematic view of the biopsy forceps of FIG. 1 with the jaws closed;

FIG. 7 is an enlarged partial view of the biopsy forceps of FIG. 1 shown in a closed jaw position.

The meaning of the individual reference symbols in the figures is as follows:

1. an operation section; 2. an operating portion pull ring; 3. a flexible pincer body; 4. a clamping part; 5. a clamp way inlet luer fitting; 6. a push-pull rod; 7. a connecting rod rivet; 8. a jaw rivet; 9. a push-pull connecting rod; 10. the push-pull rod is of a hollow structure; 11. the push-pull connecting rod is of a hollow structure; 12. the connecting rod rivet is of a hollow structure; 13. the jaw rivet is of a hollow structure; 14. the jaw is of a hollow structure.

Detailed Description

The present invention will be further described with reference to the accompanying drawings. The biopsy forceps for real-time lung biopsy under the radial ultrasonic small probe can reduce the error of inserting the biopsy forceps after withdrawing the small probe or the non-real-time property of an image navigation biopsy technology to the maximum extent, and can also avoid the radioactive ray exposure of medical staff and patients during further positioning.

As shown in the attached figure 1, the bendable biopsy forceps with the hollow forceps channel for real-time biopsy of lung lesions comprises an insertion part, a forceps taking part 4 and an operation part 1.

The insertion portion has a hollow channel extending along an axis from a proximal end to a distal end, the hollow channel capable of receiving a medical instrument therethrough for image guided imaging.

The grasping portion 4 is provided at the distal end of the insertion portion 1, and includes a first metal groove at the upper portion and a second metal groove at the lower portion. The first and second metal grooves are connected by a jaw rivet 8, the jaw rivet 8 having a jaw rivet hollow structure 13, whereby it is possible to perform a pivotal movement around a common pivot axis and to engage each other to form a space for receiving a biopsy specimen, while forming an opening at the distal end. The opening is substantially equal in size to a cross-section of the hollow cavity and is located on the axis to allow passage of the medical device.

The operation part 1 is arranged at the proximal end of the insertion part and is connected with the clamping part 4 through a connecting device; the operating part 1 can drive the first metal groove and the second metal groove to perform pivoting movement through the connecting device.

In a preferred embodiment, the medical instrument is a radial endobronchial ultrasound probe or a confocal laser endomicroscopy probe for image navigation, such as an endobronchial ultrasound small probe, a confocal laser endomicroscopy probe, and an electromagnetic navigation positioning wire.

In a preferred embodiment, the proximal opening of the hollow jaw channel is located at the side of the handle portion and the distal opening is located at the root of the grasping portion 4.

In a preferred embodiment, the first metal groove and the second metal groove have a cutting structure for grasping living tissue at the biting edges on both sides of the opening.

In a preferred embodiment, the cutting structure comprises a blade disposed along the biting edge.

In a preferred embodiment, the cutting structure comprises an alligator structure disposed along the biting edge. In this embodiment, the grasping portion is a "snake-mouth forceps", i.e., the front end of the jaw is a hollow jaw structure 14 formed by a circular opening, which allows a medical instrument such as a radial ultrasonic probe to pass through, and the two sides of the jaw are in a toothed engagement manner, which facilitates tissue biopsy.

In a preferred embodiment, the connecting means is a push-link arrangement. The push-pull connecting rod structure comprises a push-pull connecting rod 9, and the push-pull connecting rod 9 has a push-pull connecting rod hollow structure 11. A push-pull connecting rod 9 is connected at the distal end to the tail ends of the first jaw and the second jaw through a connecting rod rivet 7, and is connected at the proximal end to the operating portion pull ring 2 through a push-pull rod 6, wherein the push-pull rod 6 has a push-pull rod hollow structure 10. Thus, the operation part 1 is connected to the grasping part by a push-link system, and the opening and closing of the metal jaw can be controlled by the push-pull action of the operation part pull ring 2. The push-pull rod hollow structure 10 and the push-pull connecting rod hollow structure 11 are in communication with each other to allow the passage of the medical instrument.

In a preferred embodiment, the insertion portion comprises a substantially cylindrical flexible pincer body 3 having an outer diameter of 1.8mm to 2.4 mm.

In a preferred embodiment, the hollow channel is located at the center of the flexible forceps body 3 and has an inner diameter of 1.2mm to 2.0 mm.

In a preferred embodiment, the proximal end of the hollow forceps channel is provided with a forceps channel inlet luer connector 5, so that tools such as a small endobronchial ultrasound probe, a confocal laser micro-endoscope probe, an electromagnetic navigation positioning lead and the like can enter the front end of the biopsy forceps. The hollow clamping path is positioned below the side of the operation part, the tail end of the hollow clamping path is positioned at the root part of the clamping part 4, and the hollow clamping path can be used for the ultrasonic small probe to pass through; simultaneously, a syringe can be connected for bronchoalveolar lavage/irrigation, and bronchoalveolar lavage/irrigation fluid is recovered for tumor cell/etiology detection.

The utility model is used as follows.

When peripheral lung lesions are found in chest CT examination, biopsy operation is often required to further confirm the lesion condition. The device of the utility model can be used together with an endobronchial ultrasonic probe or a confocal laser microscopy endoscope probe to carry out the quick and accurate biopsy of the peripheral lesion of the lung.

After local or general anesthesia of a patient, the bronchoscope enters the main bronchus cavity through the glottis, and enters the lung lobe or the lung segment according to the CT image data in the early stage. The endobronchial ultrasonic probe is put into the hollow clamping channel of the utility model in advance, and the front end of the ultrasonic probe enters the clamping part of the utility model, and the jaw keeps a closed state. Then the ultrasonic probe and the ultrasonic probe enter the biopsy forceps channel of the bronchoscope through the biopsy forceps channel of the bronchoscope, and the biopsy forceps channel reaches the visual range of the bronchoscope.

According to the CT image positioning, an endobronchial ultrasonic probe extends out of a jaw part of the utility model to reach the position near a focus, the endobronchial ultrasonic probe is pushed to reach the focus, after the focus is found and accurately positioned, an operation part is slowly pushed to open a biopsy forceps, the biopsy forceps are pushed forwards, and when the focus ultrasonic image disappears, the open jaw is explained to just cover the ultrasonic probe and reach the focus position. The ultrasonic probe is withdrawn by 5mm-10mm, the operation part is controlled to open the jaw and then bite, and partial focus tissues are bitten by rotating the utility model. The utility model is then removed from the biopsy channel of the bronchoscope along with the ultrasound probe, and the specimen is removed. The biopsy operation can be stopped when the tissue sample size is taken down to meet the pathological requirement.

When the confocal laser micro-endoscope probe is used for guiding biopsy, the operation process is similar to that of the endobronchial ultrasonic probe for guiding biopsy, the confocal laser micro-endoscope probe extends out of the jaw part of the utility model to reach the position near a focus according to CT image positioning, the confocal laser micro-endoscope probe is pushed to reach the focus, after the focus is found and accurately positioned, the operation part is slowly pushed to open the biopsy forceps, the biopsy forceps are pushed forwards, and when the confocal laser endoscope image of the focus disappears, the opened jaws just cover the confocal laser micro-endoscope probe and reach the focus position. The probe is retracted by 5mm-10mm, the operation part is controlled to open the jaw and then bite, and partial focus tissues are bitten by rotating the forceps. The utility model is then removed from the biopsy channel of the bronchoscope along with the ultrasound probe, and the specimen is removed. The biopsy operation can be stopped when the tissue sample size is taken down to meet the pathological requirement.

The above description is only a preferred embodiment of the present invention and is not intended to limit the present invention, and various modifications and changes may be made by those skilled in the art. Any modification, equivalent replacement, or improvement made within the spirit and principle of the present invention should be included in the protection scope of the present invention.

Claims

1. A bendable biopsy forceps accompanied with a hollow forceps channel for real-time biopsy of lung lesions is characterized by comprising

An insertion portion having a hollow jaw channel and extending along an axis from a proximal end to a distal end, the hollow jaw channel capable of receiving a medical instrument therethrough for image guided imaging;

a grasping portion provided at a distal end of the insertion portion and including a first metal groove at an upper portion and a second metal groove at a lower portion; the first metal groove and the second metal groove can perform pivoting motion around a common pivot shaft and can be mutually meshed to form a space for accommodating a biopsy specimen, and an opening is formed at the far end; said opening being substantially equal in size to the cross-section of said hollow jaw channel and being located on said axis to allow passage of said medical instrument;

2. The bendable biopsy forceps accompanied by a hollow forceps channel for real-time biopsy of lung lesions according to claim 1, wherein the medical instrument is a radial bronchial ultrasound probe or a confocal laser microscopy probe.

3. The bendable biopsy forceps with a hollow forceps channel for real-time biopsy of lung lesions, according to claim 1, wherein the proximal opening of the hollow forceps channel is located at the side of the operation part, and the distal opening is located at the root of the forceps taking part.

4. The bendable biopsy forceps with hollow forceps channel for real-time biopsy of lung lesions, according to claim 1, wherein the biting edges of the first metal groove and the second metal groove on both sides of the opening have cutting structures for grasping living tissue.

5. The bendable biopsy forceps with a hollow tract for real-time biopsy of lung lesions according to claim 4, wherein the cutting structure comprises a blade edge disposed along the biting edge.

6. The bendable biopsy forceps with a hollow forceps channel for real-time biopsy of a lung lesion of claim 4, wherein the cutting structure comprises an alligator structure disposed along the biting edge.

7. The bendable biopsy forceps with hollow forceps channel for real-time biopsy of lung lesions of claim 1, wherein the connecting device is a push link structure connected to the tail ends of the first metal groove and the second metal groove at the distal end and connected to the pull ring of the operation part at the proximal end.

8. The bendable biopsy forceps with hollow forceps channel for real-time biopsy of lung lesions of claim 1, wherein the insertion part comprises a substantially cylindrical flexible forceps body with an outer diameter of 1.8mm to 2.4 mm.

9. The bendable biopsy forceps accompanied by a hollow forceps channel for real-time biopsy of lung lesions, according to claim 8, wherein the hollow forceps channel is located at the center of the flexible forceps body and has an inner diameter of 1.2mm-2.0 mm.

10. The bendable biopsy forceps accompanied by a hollow forceps channel for real-time biopsy of lung lesions, according to claim 9, wherein the proximal end of the hollow forceps channel is provided with a luer fitting.