CN219207302U - Bile duct laser lithotripter positioning auxiliary equipment - Google Patents

Abstract

The utility model relates to bile duct laser lithotripter positioning auxiliary equipment, which comprises a control device and a lithotripter, wherein the lithotripter comprises an outer tube, an inner tube, a string bag traction wire, a laser probe, an optical fiber, a wire guide lug and a pushing wire guide, and the wire guide lug is arranged in the outer tube; the wire guide lug is provided with a wire guide hole; the top of the inner pipe is provided with a net bag; a string bag traction wire is connected below the string bag; the inner tube is provided with a metal mark; the inner tube is inserted with an optical fiber; and a laser probe is arranged at the top of the optical fiber. The advantages are as follows: the net bag is added to assist the laser probe to keep accurate contact with the approximate center position of the stone, the stone crushing efficiency is improved, the inner tube is also a soft lens, the operation difficulty is greatly reduced, the time for switching the pushing guide wire and the optical fiber is reduced due to the addition of the guide wire ear, the operation duration is shortened, the mark is arranged on the inner tube, the lens feeding length and the relative distance between the lens and the stone are convenient to judge under perspective, the cost is low, the operation is simple, and the clinical application prospect is wide.

Description

Bile duct laser lithotripter positioning auxiliary equipment

[ field of technology ]

The utility model relates to the technical field of bile duct laser lithotripsy, in particular to bile duct laser lithotripsy positioning auxiliary equipment.

[ background Art ]

The incidence of gallstones is continuously rising, and about 10% -15% of gallstone patients progress to symptomatic gallstone symptoms within 10 years. Typically manifested as symptoms of gall abdominal pain, jaundice, fever, etc. Serious complications include acute suppurative cholangitis, acute pancreatitis, etc. With the rapid development of the endoscope technology, the minimally invasive surgical treatment of the endoscope has become a main treatment means. Endoscopic lower sphincterotomy (EST) under ERCP guidance combined balloon or basket device can clear 85% -90% of non-complex bile duct stones, cut off deep muscles of the Oddi sphincter through the bile duct sphincterotomy, thereby solving the major anatomical obstacle on the stone extraction path.

Bile duct (extrahepatic bile duct), the liver secretes bile and conveys to the duodenum through this pipeline, in order to divide the gall bladder tube leading to the gall bladder as the boundary, above is the common hepatic duct, below is the common bile duct, the end of common bile duct is the sphincter (oddi sphincter), namely the part that interfaces with the duodenum, the endoscopic lower sphincterotomy (EST) under the ERCP guide incorporates sacculus or basket device, namely the common bile duct and pancreatic duct outlet (the large duodenal papilla) through the duodenum against the flowing direction of bile, and retrograde enters the common bile duct to carry out stone extraction. The duodenoscope can not enter the common bile duct, in order to judge the condition of the common bile duct, a thinner tube is inserted into the common bile duct, contrast medium is injected into the common bile duct, whether the contrast medium in the common bile duct is full or not is observed under X rays, whether space occupying lesions exist or not is judged, the technology is ERCP (Endoscopic Retrograde Cholangiopancreatography), after the common bile duct stones are determined, sphincters (odddis sphincters) at the tail end of the common bile duct, namely EST (expressed test) can be properly cut, the tail end of the common bile duct is opened, and stones are conveniently taken out. Balloon devices, basket devices are commonly used for patients with multiple small stones (1 cm or less). But facing 10% -15% of complex bile duct stones (diameter >1.5cm, number >3, compact stones, are positioned at bile duct stenosis, are embedded in bile duct or liver, bile duct tortuosity, and anatomical structure change after ampulla stenosis or diversion operation, etc.), the success rate is low because the basket can not completely take stones, often the basket is clamped, broken, etc. together. For such complex bile duct large stones, surgical treatment is traumatic and has many complications, and is not accepted at present. In recent years, although the center of part of the endoscope adopts the laser lithotripsy under the direct vision guided by the oral cholangioscope to treat complex bile duct stones, so as to obtain better treatment effect, the cholangioscope laser lithotripsy technology has a plurality of difficulties, such as harder body of the cholangioscope, difficult bending, difficult passing through a narrow bile duct, high operation difficulty and higher requirements on equipment conditions and experience of operators, so the cholangioscope laser lithotripsy technology still cannot be widely popularized until now.

Chinese patent application: CN213787662U discloses an ERCP rubble basket, including basket body, pipe, basket traction wire and control handle, wear to be equipped with the rubble electrode in the pipe, wear out to the pipe upper end outside in rubble electrode upper end, the basket body includes mounting and many basket wires, many basket wires outside all cladding have first nontoxic insulating layer, the cladding of rubble electrode outside has the nontoxic insulating layer of second. The advantages are as follows: the utility model has low production cost, convenient use and good popularization, can quickly break up larger stones through the arrangement of the stone breaking electrode, improves the stone breaking effect, reduces the operation time, simultaneously avoids the mesh basket from being embedded, avoids the further damage of the Oddis sphincter, and separates the mesh basket body from the stone breaking electrode through the arrangement of the first non-toxic insulating layer and the second non-toxic insulating layer, thereby avoiding the damage of bile ducts. But the basket in the ERCP lithotripter basket is used for taking lithotripter through a net, the front end of the basket is provided with a fixing piece, lithotripter is conveniently sleeved, the net bag is used for providing positioning assistance for the lithotripter of the laser probe, has high elasticity, has a certain supporting force, supports the wall of the bile duct, assists the laser probe to align to the position of the relative center of the lithotripter, improves lithotripter efficiency, reduces the risk of damage of the bile duct, is not provided with a pushing guide wire for guiding the device, and the bile duct is narrow and bent, and enters the bile duct only by contrast to easily injure the bile duct, so that a series of subsequent complications are caused.

In view of the foregoing, there is a need for a bile duct laser lithotripter positioning auxiliary device that not only can efficiently remove stones, avoid damaging bile ducts, but also can be equipped with a positioning auxiliary device to reduce operation difficulty, and is equipped with a guide wire ear capable of placing a push guide wire, thereby reducing switching equipment time, shortening operation time, and having the capability of judging the length of a endoscope and the relative distance between the endoscope and stones.

[ utility model ]

The utility model aims to provide the bile duct laser lithotripter positioning auxiliary equipment which not only can efficiently remove stones, avoid damaging bile ducts, but also can be provided with a positioning auxiliary device to reduce operation difficulty, is provided with a guide wire ear to place a push guide wire, reduces equipment switching time, shortens operation time and has the capability of judging the length of an endoscope and the relative distance between the endoscope and the stones.

In order to achieve the above purpose, the technical scheme adopted by the utility model is as follows:

the bile duct laser lithotripter positioning auxiliary equipment comprises a control device and a lithotripter, wherein the lithotripter comprises an outer tube, an inner tube, a string bag traction wire, a laser probe, an optical fiber, a wire guide lug and a pushing wire guide lug, and the wire guide lug is arranged on the inner wall of the outer tube; the upper end face of the wire guide lug is provided with a wire guide hole, and the pushing wire guide passes through the wire guide hole and is placed on the wire guide lug; the top end of the inner pipe is provided with a net bag which is unfolded to be in an inverted umbrella shape; the lower end of the net bag is connected with a net bag traction wire; the lower end of the string bag traction wire is connected with a control device; a metal mark is fixed on the inner tube; an optical fiber is inserted into the inner tube; and a laser probe is arranged at the top of the optical fiber.

As a preferable example, the net bag is made of memory metal.

As another preferable example, the inner tube is a soft mirror.

As another preferred example, the metal marker is a radiopaque marker.

As another preferred example, the push wire is of a smaller diameter.

The utility model has the advantages that:

1. according to the utility model, the inverted umbrella-shaped net bag is additionally arranged, the net bag is woven by memory metal, has high elasticity, is easy to deform, is convenient to expand and retract, has a certain supporting force, enables the laser probe to be arranged in the center of the net bag, expands the bile duct wall after the net bag is close to a stone, assists the laser probe to keep accurate contact with the approximate center position of the stone, improves the stone crushing efficiency, reduces the risk of damaging the bile duct wall by laser, simultaneously provides more adjustable space for the work of the laser fiber, is not easy to damage the bile duct wall even under blind operation, and greatly reduces the operation difficulty.

2. According to the utility model, the guide wire ear for placing the push guide wire is added, the push guide wire and the optical fiber use the same channel in the traditional device, two devices can be switched back and forth in operation, so that the operation time is wasted, after the guide wire ear is added, the push guide wire can be temporarily stored in the guide wire ear at the side of the outer tube, the push guide wire does not need to be pulled out during stone breaking, the laser optical fiber can be directly placed in, the time for switching the push guide wire and the laser optical fiber is reduced, the operation efficiency is improved, and the operation time is shortened.

3. The inner tube is integrally a soft mirror, has a thin tube diameter and flexible direction, is convenient for exploring a narrow bile duct, is not easy to cause the breakage of optical fibers during bending, reduces the operation difficulty, can reduce the equipment cost, relieves the economic burden of a patient, is easy to popularize, is also provided with a radiopaque marker mark, is convenient for judging the length of an endoscope under perspective, and is used for knowing the relative distance among a laser fiber, a string bag and stones.

4. The utility model has low cost and simple operation, reduces various complications caused by improper operation in bile duct laser lithotripsy, and has wide clinical application prospect.

[ description of the drawings ]

FIG. 1 is a perspective view of a control device and lithotripter of a bile duct laser lithotripter positioning auxiliary device of the present utility model.

Fig. 2 is a partial enlarged view of a lithotripter at a position A of a bile duct laser lithotripter positioning auxiliary device of the utility model.

[ detailed description ] of the utility model

The utility model is further described below with reference to examples and with reference to the accompanying drawings.

Reference numerals and components referred to in the drawings are as follows:

example 1

Referring to fig. 1 and 2, fig. 1 is a perspective view of a control device and a lithotripter of a bile duct laser lithotripter according to the present utility model, and fig. 2 is a partial enlarged view of the lithotripter at a site of the bile duct laser lithotripter according to the present utility model. The bile duct laser lithotripter positioning auxiliary equipment comprises a control device and a lithotripter, wherein the lithotripter comprises an outer tube 1, an inner tube 2, a string bag 3, a string bag traction wire, a laser probe 4, an optical fiber 5, a wire guide lug 6 and a pushing wire guide lug 7, and the wire guide lug 6 is arranged on the inner wall of the outer tube 1; the upper end face of the wire guide lug 6 is provided with a wire guide hole, and the pushing wire guide 7 passes through the wire guide hole and is arranged on the wire guide lug 6; the top end of the inner tube 2 is provided with a net bag 3, and the net bag 3 is unfolded to be in an inverted umbrella shape; the lower end of the net bag 3 is connected with a net bag traction wire; the lower end of the string bag traction wire is connected with a control device, the center of the control device is of a hollow structure, optical fibers and the like can be inserted into the control device, and the control device can also control the release and retraction of the string bag 3 through the string bag traction wire; a metal mark 8 is fixed on the inner tube 2; an optical fiber 5 is inserted into the inner tube 2, and the optical fiber 5 can conduct laser; the top of the optical fiber 5 is provided with a laser probe 4, and the laser probe 4 can emit laser.

In this embodiment, the preferred net bag 3 is made of memory metal, has large elasticity, is easy to deform, is convenient to expand and retract, has a certain supporting force, can prop open the bile duct wall, helps the laser probe to keep accurate contact with the approximate center position of the stone, and enables the stone to be finer and more thorough, if the optical fiber 5 is aligned with the edge stone of the stone, the stone fragments which are instantaneously burst may cause mechanical damage to the bile duct, causing a series of complications.

In this embodiment, the inner tube 2 is preferably a soft lens, which has a smaller tube diameter and flexible direction, is convenient for probing a narrow bile duct, is not easy to cause the breakage of the optical fiber during bending, and has low cost and easier popularization.

In this embodiment, the metal marker 8 is preferably a radiopaque marker to facilitate understanding of the endoscope length and relative distance from the stone.

In this embodiment, the pushing guide wire 7 is preferably smaller in diameter, so that the net bag 3 and the optical fiber 5 can be guided to reach the stone position for stone breaking, and the subsequent stone breaking can be conveniently discharged.

The application method and principle of the utility model are as follows: when the device is used, under ERCP equipment, the duodenal papilla is found through conventional operation and is subjected to radiography, the position and the size of the gall bladder are positioned, after the papilla is cut, the push guide wire 7 arranged on the guide wire ear 6 is sent into a bile duct, after the push guide wire 7 is inserted, the inner tube carries the contracted string bag 3 into the bile duct, the metal mark 8 can judge the length of the endoscope, the distance between the string bag 3 and the gall bladder is known, after the gall bladder is reached, the control device controls the string bag to pull the string bag 3, the string bag 3 is unfolded to support the gall bladder wall, the flexible and easily-changeable string bag 3 can not hurt the gall bladder wall while supporting the gall bladder wall, the optical fiber 5 is inserted into the inner tube 2, the laser probe 4 is enabled to keep accurate contact with the approximate center position of the gall bladder to release laser, the large gall bladder is broken into fragments, the gall bladder is prevented from being damaged by the laser under the blind operation condition, the optical fiber is retracted 5 and the inner tube 2 after the gall bladder is broken, the conventional operation of taking the crushed stone is performed subsequently, and the crushed stone is taken out by the push guide wire 7.

It should be noted that, the inverted umbrella-shaped net bag 3 is added, the net bag 3 is woven by memory metal, the elasticity is high, the deformation is easy, the expansion and the retraction are convenient, meanwhile, a certain supporting force is provided, the laser probe 4 is arranged at the center of the net bag 3, the net bag 3 expands to prop the bile duct wall after approaching to stones, the laser probe 4 is assisted to keep accurate contact with the approximate center position of the stones, the stone crushing efficiency is improved, the risk of damaging the bile duct wall by laser is reduced, more adjustable space is provided for the work of the laser probe 4, the damage to the bile duct wall is not easy to happen even under the blind operation condition, the operation difficulty is greatly reduced, the guide wire 7 and the optical fiber 5 are pushed in the traditional device, the same channel is used, the operation time is wasted when two devices are switched back and forth in the operation, after the guide wire ear 6 is pushed, the guide wire 7 is temporarily stored at the side of the outer tube, the push wire 7 is not required to be pulled out when the stone is crushed, the operation time for switching the push wire 7 and the optical fiber 5 is directly put into the laser 5, the operation efficiency is shortened, and the operation time is shortened. The whole inner tube 2 is a soft mirror, the tube diameter is thin, the direction is flexible, the narrow bile duct is convenient to explore, the optical fiber is not easy to break during bending, the operation difficulty is reduced, the equipment cost is reduced, the economic burden of a patient is relieved, the popularization is easy, the radiopaque marker mark is further arranged on the inner tube 2, the mirror entering length is convenient to judge under perspective, and the relative distance between the laser probe 4, the net bag 3 and the stones is known. The utility model has low cost and simple operation, reduces various complications caused by improper operation in bile duct laser lithotripsy, and has wide clinical application prospect.

The foregoing is merely a preferred embodiment of the present utility model and it should be noted that modifications and additions to the present utility model may be made by those skilled in the art without departing from the principles of the present utility model and such modifications and additions are to be considered as well as within the scope of the present utility model.

Claims (4)

1. The bile duct laser lithotripter positioning auxiliary equipment comprises a control device and a lithotripter, and is characterized in that the lithotripter comprises an outer tube, an inner tube, a string bag, string bag traction wires, a laser probe, an optical fiber, wire guide lugs and pushing wire guides, wherein the wire guide lugs are arranged on the inner wall of the outer tube; the upper end face of the wire guide lug is provided with a wire guide hole, and the pushing wire guide passes through the wire guide hole and is placed on the wire guide lug; the top end of the inner pipe is provided with a net bag which is unfolded to be in an inverted umbrella shape; the lower end of the net bag is connected with a net bag traction wire; the lower end of the string bag traction wire is connected with a control device; a metal mark is fixed on the inner tube; an optical fiber is inserted into the inner tube; and a laser probe is arranged at the top of the optical fiber.

2. The bile duct laser lithotripsy positioning auxiliary device according to claim 1 wherein the net bag is made of memory metal.

3. The bile duct laser lithotripsy positioning auxiliary apparatus according to claim 1 wherein the inner tube is a soft mirror.

4. The bile duct laser lithotripsy positioning aid according to claim 1, wherein the metal marker is a radiopaque marker.

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