Background technology
The modal urinary incontinence of women comprises the urgent mixed urinary incontinence of stress incontinence, urge incontinence and pressure.Wherein common with stress incontinence, be meant the patient in cough, sneeze, when abdominal pressure such as laugh, stand up increases suddenly, urine is out of hand and flow out in spite of oneself.Especially giving birth among child's the women had the difficult labour history or suffered from uterine prolapse, bladder and urethra bulging person.After the old menopause of women, owing to lack estrogen, cause the urethra attenuation, the resistance by urethra is reduced, urinary incontinence more more to be seen.
Recognize in instructing according to adult's urinary incontinence clinical practice of being delivered by health policy and research institution recently that the number of U.S.'s urinary incontinence is 1,000 3 hundred ten thousand, 85% to be the women, the estimation age is that 30~59 years old women about 1/4 once lived through urinary incontinence.Urinary incontinence can betide children's and adolescence, but the old people is in the majority.Live in its urinary incontinence incidence rate of old people in family or the long term care facilities greater than 50%.Found that according to the sampling survey in Chongqing and two places, Beijing in 2002 of national urinary incontinence centre of prevention and cure: 18~28 years old incidence rate of women is 9.6%, 29~39 years old incidence rate is 19.2%, 40~49 years old incidence rate is 34.1%, 50~59 years old incidence rate is 46.1%, 60~69 years old incidence rate is 53.8%, more than 70 years old is 68.2%, and the male is rare.Urinary incontinence has been listed in one of the world's five big diseases.
The therapeutic modality of stress incontinence has multiple, and the curative effect of its operative treatment is ideal, and the suspender art is an effective method the most in the operative treatment, is considered to treat the classical art formula of female stress urinary incontinence always, and its cure rate is 85~90%.Present operation process is to pass patient's lower abdomen thigh film by a crooked puncture instrument, draw a suspender belt, urethra is suspended in midair, make when abdominal pressure increases suddenly, suspender belt also tightens up in response to increasing of abdominal pressure simultaneously to improve urethra, increase urethral resistance, thereby avoided overflowing of urine, reach therapeutic purposes.The piercing process of this operation is not visible, exist and wear out bladder, the risk of blood vessel etc., therefore the clinical experience to the doctor requires high, the hospital that can carry out also often will enter bladder by cystoscope and carry out indirect observation, have only this moment when puncturing head and run into just can realize whether cause danger when lateral wall of urinary bladder produces pressure to bladder near bladder, but can not realize the dislocation of other direction, can not prevent unexpected generation effectively, be limited to above-mentioned difficult point, the hospital and the doctor that can carry out this operation at present are few, the hospital that is limited to some medical conditions and facility advanced person can carry out more, can not satisfy present so many treatment demand.
Summary of the invention
Technical problem to be solved in the utility model is to overcome the shortcoming of above-mentioned urinary incontinence operative treatment with perforator, and a kind of reasonable in design, result of use good, operative treatment is visual vagina sting operation to treat pressure urinary incontinence visual puncturing device is provided.
The technical scheme that solves the problems of the technologies described above employing is: be provided with body tube at the intravital rear side of primary mirror, the cone of mirror pipe is housed in being provided with in the front end, body tube be provided with outward connect with main mirror and in the eyepiece hood of eyepiece glass is installed, in body tube, be provided with spacer shell, at mirror pipe front end front end is set object lens glass is installed, the rear end is equipped with the front end of object lens, front end is provided with puncturing head, the interior pipe of picture rod is housed in being provided with in the mirror pipe, being provided with an end between mirror pipe and the interior pipe connects with the light beam chuck, the biography light beam that the other end connects with object lens, the light beam chuck is outside equipped with light beam and takes over, the rear end of picture rod is passed spacer shell and is arranged in the excellent chuck of picture, the stop nut that connects with spacer shell is arranged on outside the excellent chuck of picture, the rear end of picture rod is provided with optical lens in body tube, the outer tube that connects with main body is arranged on outside the mirror pipe, the plane is processed in the both sides of mirror pipe, constitute intake tunnel and backwater channel between mirror pipe outer wall and the outer tube wall, main body is provided with inlet valve that links with intake tunnel and the backwater valve that links with backwater channel.
Outer tube of the present utility model and mirror pipe are arc tube, and the radius R of the centrage of outer tube and mirror pipe is 250~500mm.
The front end of outer tube of the present utility model axially is processed with the twice direct through groove at least, is processed with draw-in groove on the excircle of front end.
Puncturing head of the present utility model is: support is provided with skeleton, and the front end of skeleton is provided with the inner transparent shield of cavity that is.
Skeleton of the present utility model was made of crossing connection of a main framing and a fibula frame.
The leading section of main framing of the present utility model and fibula frame is that R is the circular arc of 6~8mm, open rearward end, the surface is the rectangle stainless steel metal frame structure of black, the angle of two medial surface of main framing and fibula frame front end is 60 °~150 °, the front end inner shafts of main framing is to being processed with width and the identical direct through groove of fibula frame thickness, two inboards, rear end are processed with projection, two outsides are processed with projection, the front end outboard shafts of fibula frame is to being processed with the width direct through groove identical with main framing thickness, front end two outsides are processed with or do not have curved hook, and two inboards, rear end are ledge structure, two outsides are processed with two projections.
The thickness of main framing of the present utility model and fibula frame is 0.1~0.5mm.
Support of the present utility model is a tubular, the support inboard be processed with the front end excircle on the step of draw-in groove clamping, two lateral surface of support are the cylinder curved surface, in addition two sides are the plane, axially are processed with the width straight trough identical with main framing thickness one at the cylinder curved surface of two lateral surface of support.
Transparent shield of the present utility model is: the rear end is that diameter cylinder, the front end identical with fibula frame width with main framing are that radius is that ball-crown body, the middle part of 0.5~4mm is to be that rotating shaft is the annular solid of 6~8mm circular arc rotation with radius with main framing and fibula frame symmetrical center line, the front end of this annular solid and ball-crown body outer surface kissing connect, the outer surface kissing of rear end and cylinder connects, and are processed with into water through hole and water outlet through hole on this transparent shield.
The thickness of transparent shield of the present utility model is 0.2~0.8mm.
This utility model has adopted endoscope has been installed in the puncture tube, realized the purpose of Real Time Observation when puncture in the limit in operation, avoided the blind potential risk that exists in the operation process of wearing, in the operation process of treatment female stress urinary incontinence, the alternative existing blind puncture instrument of looking, realize the visual of piercing process, easily endoscope is taken out from puncture tube after the operation, be convenient to clean, at the puncture tube front end dismountable puncturing head is set, can make endoscope form the passage that can observe under the situation of no nature duct or cavity on the human body, be convenient to the usefulness of operation or other treatment, puncturing head is disposable use, avoided cross infection, this utility model is through clinical trial, and it is reasonable in design to prove that it has, therapeutic effect is good, advantages such as operative treatment is visual can be used for treating the female stress urinary incontinence operation.
The specific embodiment
Below in conjunction with drawings and Examples this utility model is further described, but this utility model is not limited to these embodiment.
Embodiment 1
At Fig. 1,2, in 3, the vagina sting operation to treat pressure urinary incontinence visual puncturing device of present embodiment is by eyepiece glass 1, eyepiece hood 2, body tube 3, the excellent chuck 4 of picture, stop nut 5, light beam chuck 6, light beam takes over 7, pass light beam 8, main mirror 9, locking cap 10, cone 11, main body 12, puncturing head 13, interior pipe 14, outer tube 15, mirror pipe 16, alignment pin 17, spacer shell 18, picture rod 19, optical lens 20, inlet valve 21, backwater valve 22, front end 23, object lens 24, object lens glass 25 connects formation, wherein by main body 12, outer tube 15, inlet valve 21, backwater valve 22 is connected into puncture tube, and other parts except that puncturing head 13 are connected into endoscope.
Rear side in main mirror 9 is equipped with by thread connection cone 11 is installed in body tube 3, the front end, and cone 11 external locking caps 10 are installed with main body 12.The outer cover of body tube 3 is equipped with eyepiece hood 2, the outside of eyepiece hood 2 connects by the rear end in screw thread and the main mirror 9, eyepiece glass 1 is installed in eyepiece hood 2, body tube 3 connects with main mirror 9 by screw thread spacer shell 18 is compressed, one end of alignment pin 17 inserts in the main mirror 9, is used to prevent that spacer shell 18 from radially rotating.The rear end of outer tube 15 connects with main body 12 welding, the outer tube 15 of present embodiment is an arc tube, the centrage arc radius R of outer tube 15 is 400mm, outer tube 15 front ends axially are processed with the twice direct through groove symmetrically, be set with mirror pipe 16 in the outer tube 15, the rear end of mirror pipe 16 is installed in the center of cone 11, the radius R of the centrage of mirror pipe 16 is 400mm, a plane is milled into milling cutter in the left and right sides of the mirror pipe 16 of present embodiment, after being installed in the outer tube 15, mirror pipe 16 constitutes two passages between mirror pipe 16 outer walls and outer tube 15 inwalls, passage of left surface is an intake tunnel, and passage of right flank is a backwater channel.Mirror pipe 16 front ends connection in outer tube 15 is equipped with front end 23, and object lens 24 are installed in the front end 22, and the front end of object lens 24 is equipped with object lens glass 25, is processed with draw-in groove on the excircle of front end 23.Pipe 14 in mirror pipe 16, being set with, be equipped with between mirror pipe 16 and the interior pipe 14 and pass light beam 8, pass light beam 8 and be used for transmission light source, an end that passes light beam 8 is installed on the light beam chuck 6, bonding with glue and light beam chuck 6, the other end that passes light beam 8 sticks with glue on the cylindrical that is connected on object lens 24, and light beam chuck 6 connects with main mirror 9 by external screw thread, and the outside of light beam chuck 6 is equipped with light beam and takes over 7.When undergoing surgery treatment, light beam takes over 7 can connect external cold light source, and external cold light source is transferred to the object lens light output end in 24 1 weeks through passing light beam 8, for this utility model provides lighting source when undergoing surgery treatment.Main body 12 pass on left that thread connection is equipped with inlet valve 21, the right side is equipped with backwater valve 22 by thread connection, main body 12, outer tube 15, inlet valve 21, backwater valve 22 are connected into puncture tube, intake tunnel between inlet valve 21 and mirror pipe 16 outer walls and outer tube 15 inwalls links, and the backwater channel between backwater valve 22 and mirror pipe 16 outer walls and outer tube 15 inwalls links.In carrying out urinary incontinence operative treatment process, water enters from inlet valve 21, flow down through the side of intake tunnel from front end 23, the blood and the body fluid of object lens glass 24 front end faces are washed out, so that operator can observe the situation that operation is carried out at any time, blood that sweeps away and body fluid are entered by the another side of front end 23, flow out from backwater valve 22 through backwater channel.In interior pipe 14, be set with picture rod 19, pass spacer shell 18 as the rear end of rod 19 and be installed in the excellent chuck 4 of picture, be used for images as rod 19.Stop nut 5 is installed in outside the excellent chuck 4 of picture, and stop nut 5 connects with spacer shell 18 by external screw thread, and stop nut 5 is used for restriction and moves axially as excellent chuck 4.The rear end of picture rod 19 is equipped with optical lens 20 in body tube 3.The structural images of inside of human body through optical lens 20, is imaged on the target surface of setting by the image of coming as rod 19 biographies through object lens glass 25, object lens 24, through being connected in the optics coupling apparatus on the eyepiece hood 2, is imaged on the video camera target surface.On front end 23 excircles, be connected with puncturing head 13 in the draw-in groove, after puncturing head 13 is installed on the front end 23, the axial twice direct through groove restriction of outer tube 15 front ends puncturing head 13 radially rotates, avoided puncturing head 13 to fall in the human body, puncturing head 13 is used at operation process the soft tissue of human body outwards being pushed open, form a space, make operator observe puncturing head and arrive the situation of inside of human body position to adjust puncture direction and dynamics by monitor, avoid in the operation puncturing damage to personal vitals, after having performed the operation puncturing head 13 is taken down, puncturing head 13 is disposable use, in case infect mutually.Other parts except that puncturing head 13 are connected into endoscope.This utility model adopts endoscope and puncture tube split to be provided with, and convenient disassembly inserts endoscope in the puncture tube during operation, after the operation endoscope is taken out in puncture tube, is convenient to cleaning and sterilizing.
In Fig. 4~11, the puncturing head 13 of present embodiment is made of support 13-1, fibula frame 13-2, main framing 13-3, transparent shield 13-4 connection.
The support 13-1 of present embodiment is a tubular, is processed with step in support 13-1 inboard, is used for this utility model to be fixed in the endoscope detaining mutually with endoscope behind the half-twist on the outer tube of support 13-1 insertion endoscope.Two lateral surface of support 13-1 are circular arc camber, the plane is processed in two sides in addition, are used for forming an intake tunnel and an exhalant canal naturally with the outer tube combination back of endoscope.The straight trough that axially is processed with one at the circular arc camber of two lateral surface of support 13-1.In the axial straight trough hole of the two lateral surface circular arc cambers of support 13-1 main framing 13-3 is installed, the front end of the front end of main framing 13-3 and fibula frame 13-2 intersects vertically mutually and constitutes the skeleton of present embodiment with laser weld, main framing 13-3 and fibula frame 13-2 make with the stainless steel metal material, the front end decussation of main framing 13-3 and fibula frame 13-2, head part in this utility model is divided into four relatively independent spaces, in the therapeutic process that undergos surgery, enlarged visual-field space, and in the visual field of endoscope, be cross wire, can light an aiming positioning action to puncture.The shape of the main framing 13-3 of present embodiment and fibula frame 13-2 is that leading section is the rectangular frame structure of circular arc, open rearward end, the angle of two medial surface of main framing 13-3 and fibula frame 13-2 front end is 100 °, thickness is 0.3mm, and the radius R of leading section circular arc is 8.73mm.The front end inner shafts of main framing 13-3 is to being processed with the direct through groove that width is 0.3mm, two inboards, rear end are processed with projection, two outsides are processed with projection, the projection of two inboards, rear end is used for main framing 13-3 is inserted in the axial straight trough hole of support 13-1 two lateral surface circular arc cambers, the front end outboard shafts of fibula frame 13-2 is to being processed with the direct through groove that width is 0.3mm, the front end both sides are processed with crooked barb, two inboards, rear end are ledge structure, two outsides, rear end are processed with two projections, two projections of its medial end portions are used for when connecting with endoscope, contract in the distortion, axially enter the outer tube bore of endoscope, bounce-back is bumped in the direct through groove of two correspondences on the outer tube of endoscope, to play the generation that prevents that puncturing head from radially rotating after rotating 90 °.Fibula frame 13-2 outboard shafts to direct through groove be used for main framing 13-3 front end and insert, main framing 13-3 and fibula frame 13-2 are intersected vertically, the front end of fibula frame 13-2 insert main framing 13-3 front end inner shafts to direct through groove after, the intersection area connects with laser weld, handle through the inferior light blackout of spray fine sand on the surface again, the surface is a black, and reflected light does not make operator can clearly observe the situation that this utility model enters the inside of human body position.But the front end of main framing 13-3 and fibula frame 13-2 is skewed crossing also, and the intersection area connects with laser weld.The crooked barb in the both sides of fibula frame 13-2 is used for when operation process traction suspender belt mainly stressed.
At Figure 12, in 13, the shape of the transparent shield 13-4 of present embodiment is: the rear end is diameter and main framing 13-3 and the identical cylinder of fibula frame 13-2 width, front end is that radius is the ball-crown body of 1.5mm, the middle part is to be that rotating shaft is the annular solid of 8.73mm circular arc rotation with the radius with main framing 13-3 and fibula frame 13-2 symmetrical center line, the front end of this annular solid and ball-crown body outer surface kissing connect, the outer surface kissing of rear end and cylinder connects, injection mo(u)lding has into water through hole and backwater through hole on the centrage of the outer surface of transparent shield 13-4, and water inlet through hole and backwater through hole are slit-like through-holes.Also can be at other position injection molded water inlet through hole and backwater through holes of transparent shield 13-4, with this utility model with after endoscope connects, the intake tunnel of the outer tube of inlet opening and endoscope links, the backwater channel of backwater hole and outer tube links, when undergoing surgery treatment, the flowing water that enters from the inlet opening can rinse out the blood that enters in the human body on transparent shield 13-4 inner surface and the outer surface, so that operator can clearly observe the situation that this utility model enters the inside of human body position.The thickness of transparent shield 13-4 is 0.3mm.But transparent shield 13-4 adopts high permeability, low haze valus, meets the injection moulding macromolecular material of medical grade standard-required.Transparent shield 13-4 is injection-moulded on the projection in the main framing 13-3 and the fibula frame 13-2 outside, and inside is cavity structure, and the effect of transparent shield 13-4 is to push tissue, forms field of view, prevents that the person tissue from stopping objective of endoscope.The structure of main framing 13-3 and fibula frame 13-2 decussation is divided into four relatively independent spaces with transparent shield 13-4 inner chamber, make illuminating ray independently form an inclination angle with transparent shield 13-4 in the cavity at each, the other secondary reflection light of illuminating ray in transparent shield 13-4 inside of putting of objective of endoscope camera lens is sponged, thereby eliminated the eyepiece camera lens that secondary and above reflection veiling glare enter endoscope, eliminated veiling glare and the generation of rolling the picture phenomenon effectively.Main framing 13-3 and fibula frame 13-2 criss-cross construction, 13-4 plays a supportive role to transparent shield, prevents that transparent shield 13-4 is directly stressed in piercing process.
Embodiment 2
In the present embodiment, the radius R of the centrage of outer tube 15 and mirror pipe 16 is 250mm.Skeleton is that the front end by the front end of main framing 13-3 and fibula frame 13-2 intersects vertically mutually and constitutes with laser weld, the shape of main framing 13-3 and fibula frame 13-2 is that leading section is a circular arc, the open rearward end rectangular frame structure, the thickness of main framing 13-3 and fibula frame 13-2 is 0.1mm, the radius R of leading section circular arc is 6mm, the angle of two medial surface of main framing 13-3 and fibula frame 13-2 front end is 60 °, the front end inner shafts of main framing 13-3 is to being processed with the direct through groove that width is 0.1mm, the front end outboard shafts of fibula frame 13-2 is to being processed with the direct through groove that width is 0.1mm, and other geometry and the physical dimension of main framing 13-3 and fibula frame 13-2 are identical with embodiment 1.Transparent shield 13-4 is that the rear end is that diameter cylinder, the front end identical with fibula frame 13-2 width with main framing 13-3 are that radius is that ball-crown body, the middle part of 0.5mm is to be that rotating shaft is the annular solid of 6mm circular arc rotation with the radius with main framing 13-3 and fibula frame 13-2 symmetrical center line, and the thickness of transparent shield 13-4 is 0.2mm.The connecting relation of other parts and parts is identical with embodiment 1.
Embodiment 3
In the present embodiment, the radius R of the centrage of outer tube 15 and mirror pipe 16 is 500mm.Skeleton is intersected vertically mutually by the front end of the front end of main framing 13-3 and fibula frame 13-2 and constitutes with laser weld, the shape of main framing 13-3 and fibula frame 13-2 is that leading section is a circular arc, the open rearward end rectangular frame structure, the thickness of main framing 13-3 and fibula frame 13-2 is 0.5mm, the radius R of leading section circular arc is 8mm, the angle of two medial surface of main framing 13-3 and fibula frame 13-2 front end is 150 °, the front end inner shafts of main framing 13-3 is to being processed with the direct through groove that width is 0.5mm, the front end outboard shafts of fibula frame 13-2 is to being processed with the direct through groove that width is 0.5mm, and other geometry and the physical dimension of main framing 13-3 and fibula frame 13-2 are identical with embodiment 1.Transparent shield 13-4 is that the rear end is that diameter cylinder, the front end identical with fibula frame 13-2 width with main framing 13-3 are that radius is that ball-crown body, the middle part of 4mm is to be that rotating shaft is the annular solid of 8mm circular arc rotation with the radius with main framing 13-3 and fibula frame 13-2 symmetrical center line, and the thickness of transparent shield 13-4 is 0.8mm.The connecting relation of other parts and parts is identical with embodiment 1.
Embodiment 4
In above embodiment 1~3, the no crooked barb in the front end of the fibula frame 13-2 outside.The connecting relation of other parts and parts is identical with respective embodiments.